Within the emerging context of the digitization of
health care, electronic health records (EHRs) constitute a
significant technological advance in the way medical information is
stored, communicated, and processed by the multiple parties involved
in health care delivery. However, in spite of the anticipated value
potential of this technology, there is widespread concern that
consumer privacy issues may impede its diffusion. In this study, we
pose the question: can individuals be persuaded to change their
attitudes and opt-in behavioral intentions toward EHRs, and allow
their medical information to be digitized even in the presence of
significant privacy concerns? To investigate this question, we
integrate an individual’s concern for information privacy (CFIP)
with the elaboration likelihood model (ELM) to examine attitude
change and likelihood of opting-in to an EHR system. We theorize
that issue involvement and argument framing interact to influence
attitude change, and that concern for information privacy further
moderates the effects of these variables. We also propose that
likelihood of adoption is driven by concern for information privacy
and attitude. We test our predictions using an experiment with 366
subjects where we manipulate the framing of the arguments supporting
EHRs provided to the subjects. We find that an individual’s CFIP
interacts with argument framing and issue involvement to affect
attitudes toward the use of EHRs. In addition, results suggest that
attitude toward EHR use and CFIP directly influence opt-in
behavioral intentions. An important finding for both theory and
practice is that even when people have high concerns for privacy,
their attitudes can be positively altered with appropriate message
framing. These results as well as other theoretical and practical
implications are discussed.
Keywords: Privacy, ELM, EHR, CFIP, attitude