University Clermont Auvergne, CleRMA, Research chair "health and territories", IAE Clermont Auvergne, France.
University of Lorraine, CEREFIGE, IUT Epinal-Hubert Curien, France.
Soc Sci Med. 2021 Aug;283:114146. doi: 10.1016/j.socscimed.2021.114146. Epub 2021 Jun 24.
Health digitalization raises important challenges for personal health-data management. Particularly, the advantages underlying the implementation of Electronic Health Record (EHR) remain limited in many countries due to patients' privacy concerns.
Drawing on the privacy calculus theory, the objective of this research is to introduce personal health concerns and trust in healthcare providers as new predictors, beyond the constituent variables of the privacy calculus model - the perceived benefits and risk. We propose and test a conceptual model that investigates simultaneously the effects of these four variables on patients' privacy concerns and intention to share personal health-data on EHR.
A cross-sectional study using an on online survey was administered from December 2019 to February 2020 in France to both users and non-users of EHR. A structural equation modelling was used to assess the reliability and validity of the measurement as well as to test the research hypotheses.
The results confirm the positive effects of personal health concerns and trust in healthcare providers on (a) the intention to create an EHR and (b) to share personal health-data. In the same vein, we do not find any significant effect of patients' privacy concerns on the intention to create an EHR and intention to share personal health-data. Furthermore, the patients' perceived benefits outweigh the perceived risks for EHR using.
This research provides a more holistic understanding of patients' privacy concerns. Particularly, we highlight the key role of personal health concerns and trust in healthcare providers with the intention to create an EHR and to share personal health data. Empirical evidence underlines the importance to involve all the stakeholders in the implementation process. Findings are discussed according to existing literature and practical guidelines are suggested to the health policymakers and healthcare providers.
健康数字化给个人健康数据管理带来了重要挑战。特别是，由于患者对隐私的担忧，电子健康记录（EHR）的实施优势在许多国家仍然有限。
本研究借鉴隐私计算理论，引入个人健康关注度和对医疗保健提供者的信任作为新的预测因素，超越隐私计算模型的构成变量-感知收益和风险。我们提出并测试了一个概念模型，该模型同时考察了这四个变量对患者隐私关注和在 EHR 上共享个人健康数据的意愿的影响。
2019 年 12 月至 2020 年 2 月，我们在法国对 EHR 的使用者和非使用者同时进行了一项横断面研究，采用在线调查的方式。使用结构方程模型评估测量的可靠性和有效性，并检验研究假设。
结果证实了个人健康关注度和对医疗保健提供者的信任对（a）创建 EHR 和（b）共享个人健康数据的意愿有积极影响。同样，我们没有发现患者隐私关注对创建 EHR 和共享个人健康数据的意愿有任何显著影响。此外，患者感知到的收益大于 EHR 使用的感知风险。
本研究提供了对患者隐私关注更全面的理解。特别是，我们强调了个人健康关注度和对医疗保健提供者的信任在创建 EHR 和共享个人健康数据的意愿中的关键作用。实证证据强调了在实施过程中让所有利益相关者参与的重要性。研究结果根据现有文献进行了讨论，并为卫生政策制定者和医疗保健提供者提出了实用建议。
