The Effectiveness of Health Care Information Technologies: Evaluation of Trust, Security Beliefs, and Privacy as Determinants of Health Care Outcomes

Abstract

BackgroundThe diffusion of health information technologies (HITs) within the health care sector continues to grow. However, there is no theory explaining how success of HITs influences patient care outcomes. With the increase in data breaches, HITs’ success now hinges on the effectiveness of data protection solutions. Still, empirical research has only addressed privacy concerns, with little regard for other factors of information assurance.ObjectiveThe objective of this study was to study the effectiveness of HITs using the DeLone and McLean Information Systems Success Model (DMISSM). We examined the role of information assurance constructs (ie, the role of information security beliefs, privacy concerns, and trust in health information) as measures of HIT effectiveness. We also investigated the relationships between information assurance and three aspects of system success: attitude toward health information exchange (HIE), patient access to health records, and perceived patient care quality.MethodsUsing structural equation modeling, we analyzed the data from a sample of 3677 cancer patients from a public dataset. We used R software (R Project for Statistical Computing) and the Lavaan package to test the hypothesized relationships.ResultsOur extension of the DMISSM to health care was supported. We found that increased privacy concerns reduce the frequency of patient access to health records use, positive attitudes toward HIE, and perceptions of patient care quality. Also, belief in the effectiveness of information security increases the frequency of patient access to health records and positive attitude toward HIE. Trust in health information had a positive association with attitudes toward HIE and perceived patient care quality. Trust in health information had no direct effect on patient access to health records; however, it had an indirect relationship through privacy concerns.ConclusionsTrust in health information and belief in the effectiveness of information security safeguards increases perceptions of patient care quality. Privacy concerns reduce patients’ frequency of accessing health records, patients’ positive attitudes toward HIE exchange, and overall perceived patient care quality. Health care organizations are encouraged to implement security safeguards to increase trust, the frequency of health record use, and reduce privacy concerns, consequently increasing patient care quality.

Enhancing Privacy Controls for Patients via a Selective Authentic Electronic Health Record Exchange Service: Qualitative Study of Perspectives by Medical Professionals and Patients

“…A recent Eurobarometer survey requested by the European Commission showed that a majority of respondents would like Web-based access to their medical records, whereas the question whether they would like to grant access to their records to third parties depends on the type of recipient [9]. Moreover, earlier studies revealed that patient- (or more generally, user-) determined privacy controls and restrictions on the content and/or recipient may be a prerequisite of sharing [10,11], whereas privacy concerns and a lack of selective controls have a negative influence on the intention to share medical information even with other health care providers [12] and may reduce patient care quality [13]. As discussed in Caine et al’s study [14], patients would like to have granular privacy controls over their health information in medical records allowing them to differentially share their data in medical records or only parts of it, depending on the data recipient of and/or type of medical data.…”

Willingness to Participate in Health Information Networks with Diverse Data Use: Evaluating Public Perspectives

“…Our survey does not presume anonymity, given this condition cannot be guaranteed for the provision of care, quality improvement, and some applications in public and private research. It further broadens the perspective for the general public, going beyond other studies that address populations receiving care or identified in ambulatory clinic settings [4849].…”

Design of a Hospice Referral System for Terminally Ill Cancer Patients Using a Standards-Based Health Information Exchange System

“…These issues have been raised not only in Korea but also in other countries. Kisekka and Giboney [ 16 ] found that privacy concerns reduce the frequency of patient access to health records use and positive attitudes towards the HIE. However, belief in the effectiveness of information security increases the frequency of patient access to health records and helps to develop a positive attitude towards the HIE.…”