Exploring Stakeholders' Perceptions of Electronic Personal Health Records for Mobile Populations Living in Disadvantaged Circumstances: A Multi-Country Feasibility Study in Denmark, Ghana, Kenya, and the Netherlands.

Abstract

Mobile populations living in disadvantaged circumstances often face disrupted continuity of care due to incomplete or inaccessible health records. This feasibility study explored the perceived usefulness of Electronic Personal Health Records (EPHRs) in enhancing access to and continuity of care for mobile populations across Denmark, Ghana, Kenya, and The Netherlands. A qualitative study using ninety semi-structured interviews, with multi-level stakeholders ranging from policymakers to mobile individuals, recruited through purposive and convenience sampling. Interview guides and analysis were informed by the Technology Acceptance Model (TAM), and analysis by the Unified Theory of Acceptance and Use of Technology (UTAUT). Stakeholders highlighted the value of improved medical data sharing and ownership and considered EPHRs promising for enhancing care continuity and efficiency. Key concerns included limited digital and health literacy, and data security and privacy, underscoring the need for education and safeguards against inappropriate data sharing. Due to differences in digital readiness and privacy guidelines, a one-size-fits-all EPHR is unlikely to succeed. EPHRs are considered valuable tools to enhance care continuity and increase patient ownership, but they face technical, structural, and social challenges, including data security and varying levels of digital (health) literacy. Successful implementation requires context-sensitive, co-created solutions supported by strong policy frameworks.