This research explores the interplay between social, legal, and technical factors toward the intention to adopt smart contracts that encode and store electronic health records (EHRs) in the U.S.A and China. The study integrates the privacy calculus model by considering the influence of smart contracts’ characteristics and the regulatory environment on the trade-off between perceived risks and benefits. The model also includes specific Hofstede’s cultural dimensions to capture the differences between U.S. and Chinese patients in developing the above trade-off. Data are collected through a survey among patients in two major hospitals in China and the U.S.A. The results of our research lead to significant contributions for academics and practitioners.