Papadopoulos Kimon, Ammenwerth Elske, Lame Guillaume, Stahl Nina, Struckmann Verena, von Wyl Viktor, Gille Felix
Digital Society Initiative (DSI), University of Zürich, Zurich, Switzerland.
Institute for Implementation Science in Health Care (IfIS), University of Zürich, Zurich, Switzerland.
Digit Health. 2025 Apr 3;11:20552076251333576. doi: 10.1177/20552076251333576. eCollection 2025 Jan-Dec.
Having public trust in national electronic health record systems (NEHRs) is crucial for the successful implementation and participation of NEHRs within a nations healthcare system. Yet, a lack of conceptual clarity precludes healthcare policymakers from incorporating trust to the fullest extent possible. In response, this study seeks to validate an existing framework for public trust in the healthcare system, which will help provide a clearer understanding of what constitutes public trust in NEHRs across members of the public in different countries, cultures, and contexts.
Twenty-four focus groups were conducted in Austria, Germany, France, Italy, the Netherlands, and Switzerland with residents of each respective country to discuss their viewpoints on our public trust in NEHRs framework in order to validate said framework.
Frameworks describing the causes and effects of public trust in NEHRs were created for each country studied. Across all countries, the frameworks remained similar to our base framework, highlighting our frameworks' robustness. Data security, privacy, and autonomy were consistently described as the most important aspects of public trust in NEHRs. Concurrently, health system actors, such as doctors, were found to have significant influence on NEHR implementation. Their influence, however, can either be beneficial or detrimental to public trust in NEHRs, depending on their actions and how the public perceives those actions. Additional results detail contextual insights into country-specific viewpoints and the role of healthcare stakeholders in public trust in NEHRs. The results showcase the differences and similarities in which different populations across Europe view trust in NEHRs in the context of our framework.
These findings present public trust frameworks in the context of NEHRs for the study countries. These frameworks can assist stakeholders in obtaining a comprehensive understanding of the complexity of public trust in implementing and promoting their NEHRs, including measurements of public trust.
让公众信任国家电子健康记录系统（NEHRs）对于NEHRs在一个国家的医疗系统中成功实施和参与至关重要。然而，概念的不清晰使得医疗政策制定者无法充分纳入信任因素。作为回应，本研究旨在验证一个现有的医疗系统公众信任框架，这将有助于更清晰地理解在不同国家、文化和背景下，公众对NEHRs的信任构成要素。
在奥地利、德国、法国、意大利、荷兰和瑞士分别与当地居民进行了24个焦点小组讨论，以探讨他们对我们的NEHRs公众信任框架的看法，从而验证该框架。
为每个研究国家创建了描述公众对NEHRs信任的因果关系框架。在所有国家中，这些框架与我们的基础框架相似，突出了我们框架的稳健性。数据安全、隐私和自主性一直被描述为公众对NEHRs信任的最重要方面。同时，发现医疗系统参与者，如医生，对NEHRs的实施有重大影响。然而，他们的影响对公众对NEHRs的信任可能是有益的，也可能是有害的，这取决于他们的行为以及公众如何看待这些行为。其他结果详细阐述了针对特定国家观点的背景见解以及医疗利益相关者在公众对NEHRs信任中的作用。结果展示了在我们的框架背景下，欧洲不同人群对NEHRs信任的异同。
这些发现呈现了研究国家在NEHRs背景下的公众信任框架。这些框架可以帮助利益相关者全面理解在实施和推广其NEHRs过程中公众信任的复杂性，包括公众信任的衡量。
