Health Consumers’ Daily Habit of Internet Banking Use as a Proxy for Understanding Health Information Sharing Behavior: Quasi-Experimental Approach
Authors: Hah Hyeyoung 
Published: October 2019

Background
As the US health care system is embracing data-driven care, personal health information (PHI) has become a valuable resource for various health care stakeholders. In particularly, health consumers are expected to autonomously manage and share PHI with their health care partners. To date, there have been mixed views on the factors influencing individuals’ health data–sharing behaviors.

Objective
This study aimed to identify a key factor to better understand health information sharing behavior from a health consumer’s perspective. We focused on daily settings, wherein health data–sharing behavior becomes a part of individuals’ daily information management activities. Considering the similarity between health and finance information management, we explicitly examined whether health consumers’ daily habit of similar data sharing from the financial domain affects their PHI-sharing behaviors in various scenarios.

Methods
A Web-based survey was administered to US health consumers who have access to and experience in using the internet. We collected individual health consumers’ intention to share PHI under varying contexts, habit of financial information management (operationalized as internet banking [IB] use in this paper), and the demographic information from the cross-sectional Web-based survey. To isolate the effect of daily IB on PHI-sharing behaviors in everyday contexts, propensity score matching was used to estimate the average treatment effect (ATE) and average treatment effect on the treated (ATET) regarding IB use. We balanced the treatment and control groups using caliper matching based on the observed confounding variables (ie, gender, income, health status, and access to primary care provider), all of which resulted in a minimal level of bias between unmatched and matched samples (bias <5%).

Results
A total of 339 responses were obtained from a cross-sectional Web-based survey. The ATET results showed that in terms of sharing contents, those who used IB daily were more likely to share general information (P=.01), current information (P=.003), and entire data (P=.04). Regarding occasions for sharing occasions, IB users were prone to share their information in all cases (P=.02). With regard to sharing recipients, daily IB users were more willing to share their personal health data with stakeholders who were not directly involved in their care, such as health administrators (P=.05). These results were qualitatively similar to the ATE results.

Conclusions
This study examined whether daily management of similar information (ie, personal financial information) changes health consumers’ PHI-sharing behavior under varying sharing conditions. We demonstrated that daily financial information management can encourage health information sharing to a much broader extent, in several instances, and with many stakeholders. We call for more attention to this unobserved daily habit driven by the use of various nonhealth technologies, all of which can implicitly affect patterns and the extent of individuals’ PHI-sharing behaviors.