Effects of privacy and security on the acceptance and usage of EMR: The mediating role of trust on the basis of multiple perspectives

Abstract

Malaysian public hospitals apply an electronic medical record (EMR) system. However, health-care professionals are facing several difficulties in trusting the EMR system in Malaysia. Studies that have addressed EMR acceptance, particularly its application in the context of privacy and security concerns on the basis of a multi-criteria perspective in Malaysian hospitals, are still lacking. This research proposed a new model testing the individual, security, and privacy factors affecting EMR acceptance and the role of trust as a mediator. The suggested model was developed on the basis of multiple perspectives targeting the health-care professionals in Malaysia. A conceptual model was developed on the basis of unified theory of acceptance and use of technology UTAUT2 to explore the relationship between individual, privacy, and security factors and the acceptance of the EMR system and the role of trust as a mediating construct. A total of 375 usable questionnaires were collected from the study population. Structural equation modeling was employed to analyze data and test the fit of the model. Two constructs, namely, security and individual, have positive influences on EMR acceptance and use. The privacy construct shows a negative effect on EMR acceptance and use. Trust mediates the effects of security, privacy, and individual factors partially, which, in turn, influences the behavioral intention to use and adopt EMR.