Disease characteristics influence the privacy calculus to adopt electronic health records: A survey study in Germany.

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
DIGITAL HEALTH Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI:10.1177/20552076241274245
Niklas von Kalckreuth, Markus A Feufel
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引用次数: 0

Abstract

Background: The electronic health record (EHR) is integral to improving healthcare efficiency and quality. Its successful implementation hinges on patient willingness to use it, particularly in Germany where concerns about data security and privacy significantly influence usage intention. Little is known about how specific characteristics of medical data influence patients' intention to use the EHR.

Objective: This study aims to validate the privacy calculus model (PCM) regarding EHRs and to assess how personal and disease characteristics, namely disease-related stigma and disease time course, affect PCM predictions.

Methods: An online survey was conducted to empirically validate the PCM for EHR, incorporating a case vignette varying in disease-related stigma (high/low) and time course (acute/chronic), with N = 241 participants, aged 18 years and older residing in Germany with no previous experience with the diseases mentioned in the respective medical reports. Participants were randomized (single-blinded) into four groups in parallel: high stigma and acute time course (n = 74), high stigma and chronic time course (n = 56), low stigma and acute time course (n = 62) and low stigma and chronic time course (n = 49). The data were analyzed using structural equation modeling with partial least squares.

Results: The model explains R² = 71.8% of the variance in intention to use. The intention to use is influenced by perceived benefits, data privacy concerns, trust in the provider, and social norms. However, only the disease's time course, not stigma, affects this intention. For acute diseases, perceived benefits and social norms are influential, whereas for chronic diseases, perceived benefits, privacy concerns, and trust in the provider influence intention.

Conclusions: The PCM validation for EHRs reveals that personal and disease characteristics shape usage intention in Germany. The need for tailored EHR adoption strategies that address specific needs and concerns of patients with different disease types. Such strategies could lead to a more successful and widespread implementation of EHRs, especially in privacy-conscious contexts.

疾病特征影响采用电子健康记录的隐私考虑:德国的一项调查研究。
背景:电子病历(EHR)是提高医疗效率和质量不可或缺的工具。它的成功实施取决于患者是否愿意使用它,特别是在德国,患者对数据安全和隐私的担忧极大地影响了使用意向。关于医疗数据的具体特征如何影响患者使用电子病历的意愿,人们知之甚少:本研究旨在验证有关电子病历的隐私计算模型(PCM),并评估个人和疾病特征(即与疾病相关的耻辱感和疾病时间进程)如何影响 PCM 预测:为了对电子病历的隐私计算模型进行实证验证,我们进行了一项在线调查,其中包括一个病例小故事,与疾病相关的耻辱感(高/低)和病程(急性/慢性)各不相同,调查对象为 N = 241 名年龄在 18 岁及以上、居住在德国、以前从未患过相关医疗报告中提到的疾病的参与者。受试者被随机(单盲)分为四组:高度成见和急性病程组(74 人)、高度成见和慢性病程组(56 人)、低度成见和急性病程组(62 人)以及低度成见和慢性病程组(49 人)。数据采用偏最小二乘法结构方程模型进行分析:结果:该模型解释了使用意愿方差的 R² = 71.8%。使用意向受感知到的益处、数据隐私问题、对提供者的信任和社会规范的影响。然而,只有疾病的时间进程而非耻辱感会影响使用意愿。对于急性疾病,感知到的益处和社会规范会对使用意向产生影响,而对于慢性疾病,感知到的益处、隐私问题和对提供者的信任会对使用意向产生影响:结论:针对电子健康记录的 PCM 验证表明,在德国,个人和疾病特征会影响使用意向。需要针对不同疾病类型患者的具体需求和关注点,制定有针对性的电子病历采用策略。这些策略可使电子病历的实施更加成功和广泛,尤其是在注重隐私的情况下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
DIGITAL HEALTH
DIGITAL HEALTH Multiple-
CiteScore
2.90
自引率
7.70%
发文量
302
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