Critical Acceptance Factors of Cloud-Based Public Health Records

Personal health records (PHR) is a tool that can be used to assist patients in health management, and cloud-based PHR is expected to effectively integrate medical resources and information, elevate overall healthcare quality, and reduce unnecessary medical costs. This study tends to explore the factors that affect users’ intention to use with regard to the Microsoft HealthVault hybrid cloud health system in Taiwan. A research model combined with Unified Theory of Acceptance and Use of Technology (UTAUT) and Task-Technology Fit (TTF) models as well as perceived risks and trust is proposed including 10 hypotheses. After conducting a series survey, in total, 254 valid questionnaires in Taiwan were received. Some preliminary findings are discussed, and it is hoped that this model can be used to explore the key factors influencing usage intent toward the HealthVault

Extending the generalizability and pragmatic contributions to solve privacy paradox

Privacy issue has increasingly become an integral part of organizations and businesses that operate within the digital era. However, heretofore, there is a lack of a systematic literature review to help scholars to integrate what has been done in previous studies when privacy issues were addressed especially the privacy paradox that still perplexes both academia and practitioners alike. Furthermore, with the inconsistency of findings regarding the privacy paradox, there is also a need to support researchers in recognizing the substantial constructs to improve the results of their empirical papers. Therefore, this paper aims to serve as an integrated review to congregate constructs that can help scholars to improve the generalizability and pragmatic contributions when addressing privacy paradox issue. Besides the conclusion that there is a lack of empirical papers on privacy paradox published in the business, management and marketing journal publications, we also synthesize constructs such as the population of the study, methodology, cross-cultural aspect and context of the study to improve the extent of the generalizability and practical contributions of empirical paper related to the privacy paradox. The limitations and implications of this study are also discussed at the end of this paper

The (In)Effectiveness of Incentives - A Field Experiment on the Adoption of Personal Electronic Health Records

Medication errors are the third-leading cause of death in the US; however, a large number of these cases could be prevented through better medication management. The aging population and the associated high number of individuals taking multiple medications regularly makes medication management even more important. Personal electronic health records (PHRs) can improve medication management significantly and thus increase patient safety. Despite unequivocal benefits for individuals, healthcare professionals, governments, insurers, and employers, the adoption rate of PHRs remains low. Therefore, we seek to identify measures that motivate individuals to adopt PHRs. Drawing on justice theory, we show that incentives in terms of personalization, as well as the signal of fair information practices, increase the adoption rate of PHRs. These effects are mediated by perceived benefits and privacy concerns, respectively. Based on counterintuitive findings on the effects of monetary compensation we start a discussion on the complexity and context-dependency of different incentives

Can Offering Patients’ Access to PHR Improve the Sustainability of HIEs?

Health Information Exchange (HIE) are multi-sided platforms that facilitate the sharing of patient health information between providers, payers, etc. across organizations within a region, community or hospital system. HIE benefits to payers and providers include lower cost, faster services, and better health outcome. These benefits are not achieved unless patients consent to share their records. In this research we investigate if HIEs can increase consent rates by offering PHR services to patients and making them active participants in the HIE system. The paper makes a theoretical contribution to research by extending the UTAT model with two types of trust that are critical for patient consent. The findings impact practice. Utilizing 395 participants in a randomized experimental survey design and multi-group invariance structural equation modeling (SEM) we find that PHR will help sustain HIE. In addition, PHR empowers trust in the system and the users

Citizens\u27 Health Information Privacy Concerns: A Multifaceted Approach

The increasing prevalence of ICTs in healthcare is transforming the health services received by patients. This transformation is in part facilitated by healthcare providers’ utilization of eHealth technologies, which provide physicians with access to the health data required to treat patients. The recent emergence of mobile health (mHealth) technologies such as mHealth applications and personal health records (PHRs) enable citizens to play a role in this transformation by presenting them with the opportunity to manage their own health. The success of both eHealth and mHealth technologies is contingent on acceptance and adoption by both physicians and citizens. However in order to ensure success, the factors driving or inhibiting acceptance and adoption of these technologies must be understood. In the existing literature, factors driving citizen acceptance of health ICTs are under-examined. This paper focuses on citizens’ health information privacy concerns (HIPC), which are regularly cited as a barrier to health ICT implementation. The paper presents a framework to investigate the influence of citizens’ HIPC on their acceptance and adoption of health ICTs. An upcoming study which tests this framework and the hypotheses presented in the paper is also outlined

Better Patient Privacy Protection with Better Patient Empowerment about Consent in Health Information Exchanges

Since HIPAA laws have permitted broad discretion to Health Information Exchange (HIE) providers, HIEs have configured the patient healthcare consent process to privilege all providers who sign up with the Health Information Exchange with patient health information (PHI) on all consenting patients. This in a sense violates the security principle of “least privilege”. The onus of denying broad based general access for a consenting patient, now resides with the patient. The notion of making the information available to all physicians at all times because they are part of an exchange is not the best practice. Patients empowered with the right information may choose to deny access to their medical records while seeking a second opinion. This research investigates the following questions: How does a more holistic education as opposed to a one-sided message impact patient consent behavior? How does the messaging framework impact the intention to consent under different sharing settings? Utilizing an experimental survey, our results show that the binary setting (share all PHI with all providers) was the least favorable among all participants, while the customized setting was the most favorable

Factors influencing utilisation of ‘free-standing’ and ‘alongside’ midwifery units for low-risk births in England: a mixed-methods study

Background Midwifery-led units (MUs) are recommended for ‘low-risk’ births by the National Institute for Health and Care Excellence but according to the National Audit Office were not available in one-quarter of trusts in England in 2013 and, when available, were used by only a minority of the low-risk women for whom they should be suitable. This study explores why. Objectives To map the provision of MUs in England and explore barriers to and facilitators of their development and use; and to ascertain stakeholder views of interventions to address these barriers and facilitators. Design Mixed methods – first, MU access and utilisation across England was mapped; second, local media coverage of the closure of free-standing midwifery units (FMUs) were analysed; third, case studies were undertaken in six sites to explore the barriers and facilitators that have an impact on the development of MUs; and, fourth, by convening a stakeholder workshop, interventions to address the barriers and facilitators were discussed. Setting English NHS maternity services. Participants All trusts with maternity services. Interventions Establishing MUs. Main outcome measures Numbers and types of MUs and utilisation of MUs. Results Births in MUs across England have nearly tripled since 2011, to 15% of all births. However, this increase has occurred almost exclusively in alongside units, numbers of which have doubled. Births in FMUs have stayed the same and these units are more susceptible to closure. One-quarter of trusts in England have no MUs; in those that do, nearly all MUs are underutilised. The study findings indicate that most trust managers, senior midwifery managers and obstetricians do not regard their MU provision as being as important as their obstetric-led unit provision and therefore it does not get embedded as an equal and parallel component in the trust’s overall maternity package of care. The analysis illuminates how provision and utilisation are influenced by a complex range of factors, including the medicalisation of childbirth, financial constraints and institutional norms protecting the status quo. Limitations When undertaking the case studies, we were unable to achieve representativeness across social class in the women’s focus groups and struggled to recruit finance directors for individual interviews. This may affect the transferability of our findings. Conclusions Although there has been an increase in the numbers and utilisation of MUs since 2011, significant obstacles remain to MUs reaching their full potential, especially FMUs. This includes the capacity and willingness of providers to address women’s information needs. If these remain unaddressed at commissioner and provider level, childbearing women’s access to MUs will continue to be restricted. Future work Work is needed on optimum approaches to improve decision-makers’ understanding and use of clinical and economic evidence in service design. Increasing women’s access to information about MUs requires further studies of professionals’ understanding and communication of evidence. The role of FMUs in the context of rural populations needs further evaluation to take into account user and community impact. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information

Adoption of Digital Allergy Card: A Mixed-Methods Approach

Due to the recent growth in the number of Personal Health Records (PHR) as well as the necessity for the development of digital solutions for reliable and accurate documentation of drug allergies, there is a need to explore digital solution as a Digital Allergy Card (DAC). Despite the advantage of using DAC, there are obstacles to taking this solution. While several studies raised privacy concerns as the key barrier to DAC adoption, there is no clear understanding of the variability of these concerns in relation to other factors which may overcome them. Therefore, drawing on situational privacy calculus theory, we propose a mixed-methods approach to assess the trade-off between perceived benefits and privacy concerns in different situations regarding DAC use. This study will provide insights to both academics and practitioners on PHR adoption by the identification of contextual determinants which can influence the adoption of a DAC

Suitability of Fast Healthcare Interoperability Resources (FHIR) for Wellness Data

Wellness data generated by patients using smart phones and portable devices can be a key part of Personal Health Record (PHR) data and offers healthcare service providers (healthcare providers) patient health information on a daily basis. Prior research has identified the potential for improved communication between healthcare provider and patient. However the practice of sharing patient generated wellness data has not been widely adopted by the healthcare sector; one of the reasons being the lack of interoperability preventing successful integration of such device generated data into the PHR and Electronic Health Record (EHR) systems. To address the interoperability issue it is important to make sure that wellness data can be supported in healthcare information exchange standards. Fast Healthcare Interoperability Resources (FHIR) is used in the current research study to identify the technical feasibility for patient generated wellness data. FHIR is expected to be the future healthcare information exchange standard in the healthcare industry. \ A conceptual data model of wellness data was developed for evaluation using FHIR standard. The conceptual data model contained blood glucose readings, blood pressure readings and Body Mass Index (BMI) data and could be extended to accept other types of wellness data. The wellness data model was packaged in an official FHIR resource called Observation. The research study proved the flexibility of adding new data elements related to wellness in Observation. It met the requirements in FHIR to include such data elements useful in self-management of chronic diseases. It also had the potential in sharing it with the healthcare provider system.

Factors driving enterprise adoption of blockchain technology

Amidst the rapidly evolving advancement of blockchain technology (BT), enterprises face notable challenges in leveraging its transformative potential, starting with a need to understand the technology and how it can be used for particular applications. Two challenges are that many BT trials have not been successful and large-scale implementations that have led to continued use are scarce. This research provides a comprehensive examination of factors that drive the successful adoption of BT for enterprise use cases. A dual-phased approach was employed. First, I introduce a taxonomy matrix correlating BT design characteristics with use case characteristics, offering a framework for BT design and benefits across different enterprise contexts. Second, I conducted case studies of five successful BT cases in large enterprises that led to the adoption in terms of continued use and contrasted them with one failure case. The data collection and analysis of the case studies encompassed technological, organizational, environmental, and inter-organizational variables that led to BT\u27s continued use. The cross-case analysis revealed that compatibility, relative advantage, and observability are primary technological factors contributing to continued use. Within the organizational dimension, organizational knowledge and internal characteristics emerged as crucial elements, while regulatory compliance came out to be a significant factor. Based on the cross-case analysis, I develop theoretical propositions about the factors that lead to the continued use of BT, which can be further validated and tested in future research