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1.
AMA J Ethics ; 26(3): E225-231, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38446727

RESUMO

What clinicians document about patients can have important consequences for those patients. Paternalistic language in patients' health records is of specific ethical concern because it emphasizes clinicians' power and patients' vulnerabilities and can be demeaning and traumatizing. This article considers the importance of person-centered, trauma-informed language in clinical documentation and suggests strategies for teaching students and trainees documentation practices that express clinical neutrality and respect.


Assuntos
Registros de Saúde Pessoal , Aprendizagem , Humanos , Estudantes , Documentação , Assistência Centrada no Paciente
2.
Nat Commun ; 15(1): 2186, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38467643

RESUMO

Cloud-based personal health records increase globally. The GPOC series introduces the concept of a Global Patient co-Owned Cloud (GPOC) of personal health records. Here, we present the GPOC series' Prospective Register of Systematic Reviews (PROSPERO) registered and Preferred Reporting Items Systematic and Meta-Analyses (PRISMA)-guided systematic review and meta-analysis. It examines cloud-based personal health records and factors such as data security, efficiency, privacy and cost-based measures. It is a meta-analysis of twelve relevant axes encompassing performance, cryptography and parameters based on efficiency (runtimes, key generation times), security (access policies, encryption, decryption) and cost (gas). This aims to generate a basis for further research, a GPOC sandbox model, and a possible construction of a global platform. This area lacks standard and shows marked heterogeneity. A consensus within this field would be beneficial to the development of a GPOC. A GPOC could spark the development and global dissemination of artificial intelligence in healthcare.


Assuntos
Inteligência Artificial , Registros de Saúde Pessoal , Humanos , Privacidade , Segurança Computacional
3.
J UOEH ; 46(1): 67-72, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38479876

RESUMO

The exact definition of a personal health record (PHR) is not clear, but it is generally defined as an electronic record of an individual's medical examination results and medication history that can be accurately tracked by the individual and family members. There are many opportunities to obtain personal PHR data in the field of occupational health, and the amount of information in a worker's PHR is enormous. It is necessary in this field to comprehensively integrate and accumulate not only information from medical examinations, but also records of the work environment and work records as personal health information.


Assuntos
Registros de Saúde Pessoal , Saúde Ocupacional
4.
JMIR Ment Health ; 11: e48008, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38306158

RESUMO

BACKGROUND: Sharing mental health notes through patient accessible electronic health records (PAEHRs) is controversial. Many psychiatric organizations and regions in Sweden have resisted the implementation, as clinicians worry about possible harms when patients are reading their notes. Despite the documented benefits of PAEHRs, there is still a lack of knowledge regarding whether patients with mental health issues could reap similar benefits of reading their notes as other patient groups. OBJECTIVE: The aim of the study is to examine the use, attitudes, and experiences of patients with mental health issues by reading their notes in the PAEHR and, moreover, whether their experiences differ from other patient groups, and if so, how. METHODS: A national patient survey was conducted with answers from 2587 patients from different patient groups. In total, 504 respondents (19.5%) indicated that they experienced a mental health disease. Answers from this patient group were compared to the answers from all other respondents. Survey questions related to attitudes, information usage, and effects on contacts with care were selected for analysis. Mann-Whitney U tests were used to detect groupwise differences. RESULTS: Patients with mental health issues use PAEHRs for checking that they have received the right care (mean_mental health 2.83, SD_mental health 1.39; mean_others 2.62, SD_others 1.37; P=.002) or suspected inaccuracies (mean_mental health 2.55, SD_mental health 1.34; mean_others 2.31, SD_others 1.30; P=.001), blocking access for professionals in other specialties (mean_mental health 3.43, SD_mental health 1.46; mean_others 3.04, SD_others 1.42; P<.001), and checking which care professionals have accessed their record (mean_mental health 4.28, SD_mental health 1.14; mean_others 4.05, SD_others 1.25; P<.001) to a significantly higher degree than other patients. On the other hand, the results show that a significantly lower proportion of patients with mental health issues (mean_mental health 3.38, SD_mental health 1.21; mean_others 3.52, SD_others 1.18; P=.02) believe that PAEHRs help them in shared decision-making compared to other patient groups. CONCLUSIONS: Patients with mental health issues who took part in the survey, as a group, express some minor differences in both the use of the PAEHR and their experiences regarding its usefulness, as compared to other patients, as a group. This patient group shows a slightly higher interest in 2 types of use: checking for accuracy of care in the record and blocking access to mental health notes for professionals from other parts of the health care system. Compared to other patient groups, these patients are less likely to experience that the PAEHR is a support in shared decision-making. The study indicates that the benefits of PAEHR on a general level are the same for this patient group as for other patients. The study does not support clinicians' worry about possible harm to this patient group. Further research is however needed.


Assuntos
Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Humanos , Saúde Mental , Pacientes , Internet
5.
PLoS One ; 19(2): e0286120, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38422025

RESUMO

Modern healthcare has a sharp focus on data aggregation and processing technologies. Consequently, from a data perspective, a patient may be regarded as a timestamped list of medical conditions and their corresponding corrective interventions. Technologies to securely aggregate and access data for individual patients in the quest for precision medicine have led to the adoption of Digital Twins in healthcare. Digital Twins are used in manufacturing and engineering to produce digital models of physical objects that capture the essence of device operation to enable and drive optimization. Thus, a patient's Digital Twin can significantly improve health data sharing. However, creating the Digital Twin from multiple data sources, such as the patient's electronic medical records (EMR) and personal health records (PHR) from wearable devices, presents some risks to the security of the model and the patient. The constituent data for the Digital Twin should be accessible only with permission from relevant entities and thus requires authentication, privacy, and provable provenance. This paper proposes a blockchain-secure patient Digital Twin that relies on smart contracts to automate the updating and communication processes that maintain the Digital Twin. The smart contracts govern the response the Digital Twin provides when queried, based on policies created for each patient. We highlight four research points: access control, interaction, privacy, and security of the Digital Twin and we evaluate the Digital Twin in terms of latency in the network, smart contract execution times, and data storage costs.


Assuntos
Blockchain , Registros de Saúde Pessoal , Humanos , Atenção à Saúde , Privacidade , Registros Eletrônicos de Saúde
6.
Stud Health Technol Inform ; 310: 1424-1425, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269678

RESUMO

Patient-Accessible Electronic Health Records (PAEHR) is particularly controversial in mental healthcare. We aim to explore if there is any association between patients with mental health conditions and the experience of someone demanding access to their PAEHR. A chi-square test showed a significant association between group belonging and experiences of someone demanding access to the PAEHR.


Assuntos
Registros de Saúde Pessoal , Transtornos Mentais , Humanos , Eletrônica , Instalações de Saúde , Sistemas Computadorizados de Registros Médicos
7.
Stud Health Technol Inform ; 310: 1426-1427, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269679

RESUMO

Personal electronic health records (PEHRs) enable patients access to their own medical records. Differences in access and use of PEHRs may create health disparities. We conducted a narrative literature review regarding the effects of race, language preference, education, income, and homelessness on PEHR usage as well as PEHRs content, particularly stigmatizing language. Of 3177 citations found, 75 articles were relevant. Patient race, language, income, and education predicted PEHR use, which could potentially exacerbate health disparities.


Assuntos
Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Humanos , Escolaridade , Eletrônica , Renda
8.
Stud Health Technol Inform ; 310: 1524-1525, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269727

RESUMO

In 2012 Australia created a national Personal Controlled Electronic Health Record (PCEHR) known as "My Health Record" (MHR). However, MHR has seen low patient utilization. Debate regarding MHR has centered on utility and moral issues (e.g. data privacy). We conducted a narrative review to assess patient perception and clinical utility of PCEHRs worldwide. Results show patient and clinician support for PCEHRs but little evidence of improved outcomes and patient concerns regarding data providence.


Assuntos
Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Humanos , Austrália , Eletrônica , Instalações de Saúde
9.
Stud Health Technol Inform ; 310: 114-118, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269776

RESUMO

While research on the effects of patient access to health records is increasing, a basic understanding of the spread of patient-accessible electronic health records worldwide is lacking. In this survey of healthcare experts with professional and personal experience from 29 countries, we explored the state of patient online record access (ORA). We asked participants whether ORA exists in their country and which information is available through it. Experts in all polled countries reported having some national access to health records, with 6 (21%) countries providing exclusively paper-based records and 23 (79%) countries having ORA. Overview of test/lab results and prescription/medication lists were the most commonly available information. Free-text clinical notes were accessible in less than half of the surveyed countries (12, 41%). We will continue to map the state of patient ORA, focusing on traditionally underrepresented countries.


Assuntos
Registros de Saúde Pessoal , Sistemas Computadorizados de Registros Médicos , Humanos , Registros , Eletrônica , Instalações de Saúde
10.
Stud Health Technol Inform ; 310: 489-493, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269857

RESUMO

Patients' online record access is a worldwide phenomenon, where Sweden is one of the pioneers in actual countrywide implementation. Healthcare professionals (HCPs) have previously raised usability issues with e-health systems and proposed several solutions, yet no studies have explored PAEHRs from this perspective. The aim of this study was to describe primary HCPs' suggestions on how the Swedish online record could be improved. They (n=14) were asked what they would like to improve with the system to increase usability and usefulness for patients or for themselves. Suggestions covered expanding what patients could view, simplification of the service for both the patients and themselves, adding feedback functions, and limiting access to only signed records.


Assuntos
Registros de Saúde Pessoal , Humanos , Pessoal de Saúde , Suécia , Atenção Primária à Saúde
11.
Stud Health Technol Inform ; 310: 499-503, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269859

RESUMO

For type 2 diabetes (T2D) patients, self-management of the disease is an essential part of the treatment. Patient portals and personal health records (PHRs) are powerful applications for self-managing T2D. It is however unclear what features of existing applications provide best support for self-management of type 2 diabetes. We retrieved and analyzed twenty-two studies to identify features which promote self-management of T2D. The results elicited 10 different features and showed that use of patient portals was associated with different health outcomes. Secure messaging, Viewing laboratory results, and Accessing medication history were the most common features, and some specific features were associated with health outcomes. In general, patient portals and PHRs were associated with improved health outcomes. Finally, nine overall recommendations for the development process of patient portals were identified.


Assuntos
Diabetes Mellitus Tipo 2 , Registros de Saúde Pessoal , Portais do Paciente , Autogestão , Humanos , Diabetes Mellitus Tipo 2/terapia , Pacientes
12.
Stud Health Technol Inform ; 310: 1041-1045, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269973

RESUMO

People are increasingly offered access to their personal health information (e.g., laboratory results, clinical notes, diagnostic imaging results). However, this information is the same as that used by health care providers with clinical expertise and training in medical terminology, which citizens typically do not have. In this study, we examined participants (N = 24) preferences for four different types of displays for online laboratory (lab) results: Tabular, Annotated, Visual, and Trends + Contextual Information. The Friedman test of difference comparing participants' ratings of the four displays was significant, χ2(3)=10.8, P=.013, and the Wilcoxon signed rank pairwise comparison tests revealed that participants rated the visual lab results display significantly more favourably than the traditional display (Z=-2.746, P=.006). These findings indicate that many people prefer lab results displayed using more visual cues and some perceived this format as easier to understand than the other display formats. Given the importance of people accessing, understanding, and using their own health information, it is crucial for displays and systems to provide a better user experience. Displaying data (e.g., lab results) visually is one possible way to improve interpretability of personal health information provided to the public.


Assuntos
Sinais (Psicologia) , Registros de Saúde Pessoal , Humanos , Pessoal de Saúde , Decoração de Interiores e Mobiliário , Laboratórios
13.
J Med Internet Res ; 25: e47840, 2023 12 25.
Artigo em Inglês | MEDLINE | ID: mdl-38145466

RESUMO

BACKGROUND: Patient-accessible electronic health records (PAEHRs) hold promise for empowering patients, but their impact may vary between mental and somatic health care. Medical professionals and ethicists have expressed concerns about the potential challenges of PAEHRs for patients, especially those receiving mental health care. OBJECTIVE: This study aims to investigate variations in the experiences of online access to electronic health records (EHRs) among persons receiving mental and somatic health care, as well as to understand how these experiences and perceptions vary among those receiving mental health care at different levels of point of care. METHODS: Using Norwegian data from the NORDeHEALTH 2022 Patient Survey, we conducted a cross-sectional descriptive analysis of service use and perceptions of perceived mistakes, omissions, and offensive comments by mental and somatic health care respondents. Content analysis was used to analyze free-text responses to understand how respondents experienced the most serious errors in their EHR. RESULTS: Among 9505 survey participants, we identified 2008 mental health care respondents and 7086 somatic health care respondents. A higher percentage of mental health care respondents (1385/2008, 68.97%) reported that using PAEHR increased their trust in health care professionals compared with somatic health care respondents (4251/7086, 59.99%). However, a significantly larger proportion (P<.001) of mental health care respondents (976/2008, 48.61%) reported perceiving errors in their EHR compared with somatic health care respondents (1893/7086, 26.71%). Mental health care respondents also reported significantly higher odds (P<.001) of identifying omissions (758/2008, 37.75%) and offensive comments (729/2008, 36.3%) in their EHR compared with the somatic health care group (1867/7086, 26.35% and 826/7086, 11.66%, respectively). Mental health care respondents in hospital inpatient settings were more likely to identify errors (398/588, 67.7%; P<.001) and omissions (251/588, 42.7%; P<.001) than those in outpatient care (errors: 422/837, 50.4% and omissions: 336/837, 40.1%; P<.001) and primary care (errors: 32/100, 32% and omissions: 29/100, 29%; P<.001). Hospital inpatients also reported feeling more offended (344/588, 58.5%; P<.001) by certain content in their EHR compared with respondents in primary (21/100, 21%) and outpatient care (287/837, 34.3%) settings. Our qualitative findings showed that both mental and somatic health care respondents identified the most serious errors in their EHR in terms of medical history, communication, diagnosis, and medication. CONCLUSIONS: Most mental and somatic health care respondents showed a positive attitude toward PAEHRs. However, mental health care respondents, especially those with severe and chronic concerns, expressed a more critical attitude toward certain content in their EHR compared with somatic health care respondents. A PAEHR can provide valuable information and foster trust, but it requires careful attention to the use of clinical terminology to ensure accurate, nonjudgmental documentation, especially for persons belonging to health care groups with unique sensitivities.


Assuntos
Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Humanos , Estudos Transversais , Emoções , Assistência Ambulatorial
14.
PLoS One ; 18(11): e0290528, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37972118

RESUMO

OBJECTIVE: To investigate public willingness to share sensitive health information for research, health policy and clinical practice. METHODS: A total of 1,003 Australian respondents answered an online, attribute-driven, survey in which participants were asked to accept or reject hypothetical choice sets based on a willingness to share their health data for research and frontline-medical support as part of an integrated health system. The survey consisted of 5 attributes: Stakeholder access for analysis (Analysing group); Type of information collected; Purpose of data collection; Information governance; and Anticipated benefit; the results of which were analysed using logistic regression. RESULTS: When asked about their preference for sharing their health data, respondents had no preference between data collection for the purposes of clinical practice, health policy or research, with a slight preference for having government organisations manage, govern and curate the integrated datasets from which the analysis was being conducted. The least preferred option was for personal health records to be integrated with insurance records or for their data collected by privately owned corporate organisations. Individuals preferred their data to be analysed by a public healthcare provider or government staff and expressed a dislike for any private company involvement. CONCLUSIONS: The findings from this study suggest that Australian consumers prefer to share their health data when there is government oversight, and have concerns about sharing their anonymised health data for clinical practice, health policy or research purposes unless clarity is provided pertaining to its intended purpose, limitations of use and restrictions to access. Similar findings have been observed in the limited set of existing international studies utilising a stated preference approach. Evident from this study, and supported by national and international research, is that the establishment and preservation of a social license for data linkage in health research will require routine public engagement as a result of continuously evolving technological advancements and fluctuating risk tolerance. Without more work to understand and address stakeholder concerns, consumers risk being reluctant to participate in data-sharing and linkage programmes.


Assuntos
Política de Saúde , Registros de Saúde Pessoal , Humanos , Austrália , Disseminação de Informação , Inquéritos e Questionários
15.
J Med Internet Res ; 25: e47841, 2023 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-37921861

RESUMO

BACKGROUND: Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC. OBJECTIVE: The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups. METHODS: Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square. RESULTS: Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were "very important," but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups. CONCLUSIONS: About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records.


Assuntos
Registros de Saúde Pessoal , Saúde Mental , Feminino , Humanos , Registros Eletrônicos de Saúde , Inquéritos e Questionários , Suécia , Masculino
16.
Stud Health Technol Inform ; 309: 262-266, 2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37869854

RESUMO

Mobile Personal Health Records (mPHRs), which make it possible to track and manage users' health information, can be an important aid in improving people's health. Despite its potential benefits, poor usability of systems can hinder the adoption and use of mPHRs. This study aims to evaluate the usability of a mobile health application in terms of perceived cognitive workload and performance. The cognitive workload experienced by 30 volunteers (15 experienced and 15 inexperienced), was measured while performing the given tasks with the NASA-Task Load Index (NASA-RTLX) scale, and the duration of the fulfillment of the tasks by eye tracking device. While there was no significant difference between the two user groups in the completion time of the tasks, a significant difference was found in the perceived cognitive load. "Making an appointment", which could take much longer to complete than other tasks, resulted in the highest cognitive load for all users. Further usability research using think-aloud protocols and user interviews could provide insights into design improvements for reducing cognitive load and enhancing performance.


Assuntos
Registros de Saúde Pessoal , Aplicativos Móveis , Telemedicina , Humanos , Carga de Trabalho , Cognição
17.
JMIR Mhealth Uhealth ; 11: e25908, 2023 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-37707310

RESUMO

Background: There is growing interest in mobile health apps; however, not all of them have been successful. The most common issue has been users' nonadoption or abandonment of health apps because the app designs do not meet their preferences. Therefore, to facilitate design-preference fit, understanding consumers' preferences for health apps is necessary, which can be accomplished by using a discrete choice experiment. Objective: This study aims to examine consumer preferences for health apps and how these preferences differ across individuals with different sociodemographic characteristics and health app usage and purchase experiences. Methods: A cross-sectional discrete choice experiment questionnaire survey was conducted with 593 adults living in Hong Kong. A total of 7 health app attributes that might affect consumers' preferences for health apps were examined, including usefulness, ease of use, security and privacy, health care professionals' attitudes, smartphone storage consumption, mobile data consumption, and cost. Mixed-effect logit regressions were used to examine how these attributes affected consumer preferences for health apps. Fixed effects (coefficient ß) of the attributes and random effects of individual differences were modeled. Subgroup analyses of consumer preferences by sex, age, household income, education level, and health app usage and purchase experiences were conducted. Results: Cost was the attribute that had the greatest effect on consumers' choice of health apps (compared to HK $10 [US $1.27]-HK $50 [US $6.37]: ß=-1.064; P<.001; HK $100 [US $12.75]: ß=-2.053; P<.001), followed by security and privacy (compared to no security insurance-some security policies: ß=.782; P<.001; complete security system: ß=1.164; P<.001) and usefulness (compared to slightly useful-moderately useful: ß=.234; P<.001; very useful: ß=.979; P=.007), mobile data consumption (compared to data-consuming-a bit data-consuming: ß=.647; P<.001; data-saving: ß=.815; P<.001), smartphone storage consumption (compared to >100 MB-around 38 MB: ß=.334; P<.001; <10 MB: ß=.511; P<.001), and attitudes of health care professionals (compared to neutral-moderately supportive: ß=.301; P<.001; very supportive: ß=.324; P<.001). In terms of ease of use, consumers preferred health apps that were moderately easy to use (compared to not easy to use-moderately easy to use: ß=.761; P<.001; very easy to use: ß=.690; P<.001). Our results also showed that consumers with different sociodemographic characteristics and different usage and purchase experiences with health apps differed in their preferences for health apps. Conclusions: It is recommended that future health apps keep their mobile data and phone storage consumption low, include a complete security system to protect personal health information, provide useful content and features, adopt user-friendly interfaces, and involve health care professionals. In addition, health app developers should identify the characteristics of their intended users and design and develop health apps to fit the preferences of the intended users.


Assuntos
Comportamento do Consumidor , Registros de Saúde Pessoal , Adulto , Humanos , Estudos Transversais , Atitude do Pessoal de Saúde , Pessoal de Saúde
18.
Front Public Health ; 11: 1213615, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37546309

RESUMO

Background: In the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the determinants and describe the measurement of the willingness to disclose personal health information. Methods: The study conducted a systematic review of articles assessing willingness to share personal health information as a primary or secondary outcome. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. English and Italian peer-reviewed research articles were included with no restrictions for publication years. Findings were narratively synthesized. Results: The search strategy found 1,087 papers, 89 of which passed the screening for title and abstract and the full-text assessment. Conclusion: No validated measurement tool has been developed for willingness to share personal health information. The reviewed papers measured it through surveys, interviews, and questionnaires, which were mutually incomparable. The secondary use of data was the most important determinant of willingness to share, whereas clinical and socioeconomic variables had a slight effect. The main concern discouraging data sharing was privacy, although good data anonymization and the high perceived benefits of sharing may overcome this issue.


Assuntos
Registros de Saúde Pessoal , Privacidade , Disseminação de Informação/métodos , Inquéritos e Questionários
19.
J Med Internet Res ; 25: e41635, 2023 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-37647102

RESUMO

BACKGROUND: Digital health has the potential to improve the quality of care, reduce health care costs, and increase patient satisfaction. Patient acceptance and consent are a prerequisite for effective sharing of personal health information (PHI) through health information exchanges (HIEs). Patients need to form and retain trust in the system(s) they use to leverage the full potential of digital health. Germany is at the forefront of approving digital treatment options with cost coverage through statutory health insurance. However, the German population has a high level of technology skepticism and a low level of trust, providing a good basis to illuminate various facets of eHealth trust formation. OBJECTIVE: In a German setting, we aimed to answer the question, How does an individual form a behavioral intent to share PHI with an HIE platform? We discussed trust and informed consent through (1) synthesizing the main influence factor models into a complex model of trust in HIE, (2) providing initial validation of influence factors based on a qualitative study with patient interviews, and (3) developing a model of trust formation for digital health apps. METHODS: We developed a complex model of the formation of trust and the intent to share PHI. We provided initial validation of the influence factors through 20 qualitative, semistructured interviews in the German health care setting and used a deductive coding approach to analyze the data. RESULTS: We found that German patients show a positive intent to share their PHI with HIEs under certain conditions. These include (perceived) information security and a noncommercial organization as the recipient of the PHI. Technology experience, age, policy and regulation, and a disposition to trust play an important role in an individual's privacy concern, which, combined with social influence, affects trust formation on a cognitive and emotional level. We found a high level of cognitive trust in health care and noncommercial research institutions but distrust in commercial entities. We further found that in-person interactions with physicians increase trust in digital health apps and PHI sharing. Patients' emotional trust depends on disposition and social influences. To form their intent to share, patients undergo a privacy calculus. Hereby, the individual's benefit (eg, convenience), benefits for the individual's own health, and the benefits for public welfare often outweigh the perceived risks of sharing PHI. CONCLUSIONS: With the higher demand for timely PHI, HIE providers will need to clearly communicate the benefits of their solutions and their information security measures to health care providers (physicians, nursing and administrative staff) and patients and include them as key partners to increase trust. Offering easy access and educational measures as well as the option for specific consent may increase patients' trust and their intention to share PHI.


Assuntos
Troca de Informação em Saúde , Registros de Saúde Pessoal , Humanos , Confiança , Intenção , Escolaridade
20.
Health Informatics J ; 29(3): 14604582231196955, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37604505

RESUMO

The use of mobile personal health records (m-PHR) has been little studied at the organizational level. This study was to investigate the relationships of various hospital-related factors with m-PHR use in Korean hospitals. Downloads of m-PHR applications for 101 hospitals were examined from May 26 to 30 June 2022. The dependent variable was the number of m-PHR downloads, and the major independent variables included six technological, organizational, and environmental factors. As technological factors, the number of computed tomography and magnetic resonance imagery devices were significantly associated with downloads (RR = 1.119, CI = 1.022-1.226, p = 0.016; and RR = 1.155; 95% CI = 1.024-1.302, p = 0.019, respectively). At the organizational level, the number of physicians, adjusting for the number of beds, and the number of medical information management staff showed significant associations (RR = 1.059, CI = 1.019-1.100, p = 0.004; and RR = 1.026, CI = 1.002-1.050, p = 0.033, respectively). From an environmental standpoint, downloads were positively associated with the proportion of the local population of working age (20-59 years) (RR = 1.102, CI 1.022-1.189, p = 0.012). Healthcare policymakers should pay close attention to these factors to advocate for the widespread use of m-PHR applications.


Assuntos
Registros de Saúde Pessoal , Aplicativos Móveis , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Atenção à Saúde , Hospitais , República da Coreia , Registros Eletrônicos de Saúde
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