Trust in Digital Health

Abstract

This thesis contributes to our understanding of the strategies and features necessary to build and maintain trust in digital health. Myriad experts foresee digital health technologies as a solution to alleviate the demands on contemporary health systems. Yet, these technologies introduce many ethical challenges, one of which is trust. Besides altering the status quo in physician-patient relationships, plenty of evidence suggests that certain digital health technologies may be unreliable or even promote detrimental behaviors. Moreover, these technologies remain increasingly susceptible to malicious actors; while a number of developers and implementers continue to act negligently. As a result, the perceived risks of digital health continue to grow and thus deteriorate trust. Since trust is imperative to the proper functioning of health systems, it is necessary to determine how to assess the trustworthiness of digital health technologies. The thesis employs both empirical and theoretical methods. The first chapter offers an introductory analysis of digital health and trust in relation to this rapidly expanding form of medical technology. Chapter 2 discusses the major ethical issues posed by digital health in a global as well as in the Swiss context. Through a scoping review of the literature, Chapter 3 identifies the facilitators and inhibitors to trust in digital health as well as the main stakeholders. Meanwhile, since precision medicine relies on diverse datasets that may be obtained from digital health technologies, Chapter 4, stipulates some requirements for trust in precision medicine. Through focus group discussions, Chapter 5 identifies trust-related expectations with respect to mobile health apps, and translates such findings into a trustworthiness checklist. In Chapter 6, the checklist is validated by relevant stakeholders via an online survey. Finally, chapter 7 discusses the overall findings of this thesis, compares it to existing research, and determines its implication

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