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The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their day-to-day work. Professionals’ discourse about privacy reveals how new technologies and laws challenge existing practices of information control within and between professional groups in health care, with implications not only for patient privacy, but also for the role of information control in professions more generally.

The authors conducted in-depth, semi-structured interviews with n=83 doctors, nurses, and health information professionals in two academic medical centers and one veteran’s administration hospital/clinic in the Northeastern USA. Interview responses were qualitatively coded for themes and patterns across groups were identified.

The health care providers and the authors studied actively sought to uphold the protection (and control) of patient information through professional ethics and practices, as well as through the use of technologies and compliance with legal regulations. They used discourses of professionalism, as well as of law and technology, to sometimes accept and sometimes resist changes to practice required in the changing technological and legal context of health care. The authors found differences across professional groups; for some, protection of patient information is part of core professional ethics, while for others it is simply part of their occupational work, aligned with organizational interests.

This qualitative study of physicians, nurses, and health information professionals revealed some differences in views and practices for protecting patient information in the changing technological and legal context of health care that suggest some professional groups (doctors) may be more likely to resist such changes and others (health information professionals) will actively adopt them.

New technologies and regulations are changing how information is used in health care delivery, challenging professional practices for the control of patient information that may change the value or meaning of medical records for different professional groups.

Qualitative findings suggest that professional groups in health care vary in the extent of information control they have, as well in how they view such control. Some groups may be more likely to (be able to) resist changes in the professional control of information that stem from new technologies or regulatory policies. Some professionals recognize that new IT systems and regulations challenge existing social control of information in health care, with the potential to undermine (or possibly bolster) professional self-control for some but not necessarily all occupational groups.

Privacy and security are coming under more and more scrutiny in this age of digital information that can be generated, duplicated, and transferred with increasing facility. Nowhere is this so apparent as in the field of health care, where breaches to security and privacy carry very personal and potentially harmful consequences. Health Information Networks must deal with these issues carefully as they seek to share sensitive information among health‐care providers to improve patient care. This article examines issues related to privacy in Health Information Networks in Canada, provides a summary of relevant federal and provincial legislation, and through a case study offers suggestions for future directions in the arena where health‐care and privacy issues meet.

Health information exchange (HIE) initiatives utilize sharing mechanisms through which health information is mostly transmitted without a patient's close supervision; thus, patient trust in the HIE is the core in this setting. Existing technology acceptance theories mainly consider cognitive beliefs resulting in adoption behavior. The study argues that existing theories should be expanded to cover not only cognitive beliefs but also the emotion provoked by the sharing nature of the technology. Based on the theory of reasoned action, the technology adoption literature, and the trust literature, we theoretically explain and empirically test the impact of perceived transparency of privacy policy on cognitive trust and emotional trust in HIEs. Moreover, the study analyzes the effects of cognitive trust and emotional trust on the intention to opt in to HIEs and willingness to disclose health information.

An online survey was conducted using data from individuals who were aware of HIEs through experience with at least one provider participating in an HIE network. Data were collected from a wide range of adult population groups in the United States.

The structural equation modeling analysis results provide empirical support for the proposed model. The model highlights the strategic role of the perceived transparency of the privacy policy in building trust in HIEs. When patients know more about HIE security measures, sharing procedures, and privacy terms, they feel more in control, more assured, and less at risk. The results also show that patient trust in HIEs may take the forms of intention to opt in to an HIE and willingness to disclose health information exchanged through HIE networks.

The findings of this study should be of interest to both academics and practitioners. The research highlights the importance of developing and using a transparent privacy policy in the diffusion of HIEs. The findings provide a deep understanding of dimensions of HIE privacy policy that should be addressed by health-care organizations to exchange personal health information in a secure and private manner.

The purpose of this paper is to investigate the threats to patient privacy inherent in the movement to reduce health care costs by digitizing health care information.

The paper applies relevant organizational theories to the health care information privacy arena, and predicts different privacy outcomes depending on the model organizations adopt to manage their information processing practices.

Public policy makers who value preservation of patient health care information privacy, can predict the relative safety of information based on the organizational model used by companies which handle that data. Propositions advanced by these theories to explain business processes are reviewed to the extent they help explore the relationships between the users and managers of the digitized health records, and the privacy of the patients' health‐records. The paper offers a series of implications for marketers based on the framework.

The findings are most applicable to health care systems that do not already sacrifice privacy in the name of economy.

The findings can be used to insure the security of health care information.

The paper addresses a recent trend motivated by the need to make health care accessible to more people. Rising health care costs have forced lawmakers and marketers to seek more efficient processes to reduce costs. One unintended consequence is that economies sacrifice privacy.

Today, e-government (electronic government) applications have extended to the frontiers of health-care delivery. E-Nabız contains personal health records of health services received, whether public or private. The use of the application by patients and physicians has provided efficiency and cost advantages. The success of e-Nabız depends on the level of technology acceptance of health-care service providers and recipients. While there is a large research literature on the technology acceptance of service recipients in health-care services, there is a limited number of studies on physicians providing services. This study aims to determine the level of influence of trust and privacy variables in addition to performance expectancy, effort expectancy, social influence and facilitating factors in the unified theory of acceptance and use of technology (UTAUT) model on the intention and behavior of using e-Nabız application.

The population of the study consisted of general practitioners and specialist physicians actively working in any health facility in Turkey. Data were collected cross-sectionally from 236 physicians on a voluntary basis through a questionnaire. The response rate of data collection was calculated as 47.20%. Data were collected cross-sectionally from 236 physicians through a questionnaire. Descriptive statistics, correlation analysis and structural equation modeling were used to analyze the data.

The study found that performance expectancy, effort expectancy, trust and perceived privacy had a significant effect on physicians’ behavioral intentions to adopt the e-Nabız system. In addition, facilitating conditions and behavioral intention were determinants of usage behavior (p < 0.05). However, no significant relationship was found between social influence and behavioral intention (p > 0.05).

This study confirms that the UTAUT model provides an appropriate framework for predicting factors influencing physicians’ behaviors and intention to use e-Nabız. In addition, the empirical findings show that trust and perceived privacy, which are additionally considered in the model, are also influential.

There is significant documentation of fraud and abuses of consumer privacy through telemarketing activities. This led to a proliferation of legislative efforts to protect consumer privacy rights in the USA. Two such federal laws, the Health Plan Portability and Accountability Act of 1996 and the Telemarketing and Consumer Protection Act of 1994 significantly improve consumer privacy protections. However, they have a negative impact on the legitimate research and customer outreach efforts of ethical firms. It is especially challenging for health care firms as personal health information is among the most highly guarded areas of privacy concern. This article describes key provisions of these laws as they relate to health care organizations. Two program examples show how one firm successfully balances effectively administering health plan operations that support customer‐focused initiatives while complying with consumer privacy regulations.

The COVID-19 pandemic represents a unique challenge for public health worldwide. In this context, smartphone-based tracking apps play an important role in controlling transmission. However, privacy concerns may compromise the population’s willingness to adopt this mobile health (mHealth) technology. Based on the privacy calculus theory, this study aims to examine what factors drive or hinder adoption and disclosure, considering the moderating role of age and health status.

A cross-sectional survey was conducted in a European country hit by the pandemic that has recently launched a COVID-19 contact-tracing app. Data from 504 potential users was analyzed through partial least squares structural equation modeling.

Results indicate that perceived benefits and privacy concerns impact adoption and disclosure and confirm the existence of a privacy paradox. However, for young and healthy users, only benefits have a significant effect. Moreover, older people value more personal than societal benefits while for respondents with a chronical disease privacy concerns outweigh personal benefits.

The study contributes to consumer privacy research and to the mHealth literature, where privacy issues have been rarely explored, particularly regarding COVID-19 contact-tracing apps. The study re-examines the privacy calculus by incorporating societal benefits and moving from a traditional “self-focus” approach to an “other-focus” perspective. This study further adds to prior research by examining the moderating role of age and health condition, two COVID-19 risk factors. This study thus offers critical insights for governments and health organizations aiming to use these tools to reduce COVID-19 transmission rates.

Expanding networks of data portals and repositories linked to electronic patient record systems, along with advances in information technology, have created both new opportunities in improving public health and new challenges in protecting patient privacy. The purpose of this paper is to review stakeholder perspectives and provide a framework for promoting implementation of current privacy protection improvement recommendations.

This paper summarizes a workshop session discussion stemming from the 2017 Information Technology and Communication in Health (ITCH) biennial international conference in Victoria, British Columbia, Canada. The perspectives within health service research, journalism, informatics and privacy protection were represented.

Problems underlying gaps in privacy protection in the USA and Canada, along with then-current changes recommended by public health leaders as well as Information and Privacy Commissioners, were identified in a session of the 2015 ITCH conference. During the 2017 conference, a workshop outlined the current situation, identifying ongoing challenges and a lack of significant progress. This paper summarizes that 2017 discussion identifying political climate as the major impediment to progress on this issue. It concludes with a framework to guide the path forward.

This paper provides an international perspective to problems, resources and solution pathways with links useful to readers in all countries.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

The collection and use of personal medical information for mobile health (mHealth) service raise significant privacy concerns. In this context, this study aims to explore the privacy paradox and its impact from the perspective of paradox resolution.

Based on social support theory and privacy calculus theory, this study first studies the effect of social support on perceived benefits, and explores the moderating effect of perceived health status on the privacy trade-off process. Secondly, the study examines the path of “privacy concerns – disclosure intention – disclosure behavior” to verify the existence of the privacy paradox. Following this, based on rational choice theory, the rationality degree is introduced as a moderating variable to investigate both its impact on the central route and the strength of this impact on the privacy paradox.

Empirical results show that informational support and emotional support influence perceived benefits significantly. Perceived benefits significantly influence privacy concerns, and perceived health status has a significant positive moderating effect. The authors further find that there is a privacy paradox within the mHealth context, and the privacy paradox is moderated negatively by rationality degree. The findings indicate that the impact strength of the privacy paradox will decrease with increases in rationality degree.

The findings indicate that it is crucial to evaluate the privacy paradox and its impact from the perspective of paradox resolution.

This study offers a complete comprehension of the privacy paradox in mHealth and provides several valuable recommendations for enhancing both mHealth services and privacy controls.