The effect of the privacy policy of Health Information Exchange (HIE) on patients’ information disclosure intention

Impact of the normativeness and intelligibility of privacy interpretation information on the willingness to accept targeted advertising -A cognitive load perspective

From the perspective of the user's psychological load, this study examined the cognitive mechanism by which privacy interpretation information affects the willingness to accept targeted advertising. Our findings provide a reference for enterprises seeking to develop and improve privacy interpretation information and reduce advertising avoidance behaviour. Based on information processing theory and cognitive load theory, this study experimentally collected volunteers' electroencephalography (EEG) data, interpreted the EEG results as representing emotions and cognitive load, and analysed the impact of the normativeness and intelligibility of privacy interpretation information on the willingness to accept targeted advertising. Intelligibility significantly affected this willingness. In the case of acceptable transparency, users were more inclined to avoid targeted advertising under low interpretability. Low interpretability caused them to expend more cognitive effort, which induced a larger N2 amplitude. In the case of unacceptable transparency, the opposite conclusion was drawn. In addition, privacy information with high interpretability was more likely to arouse users' emotions and induce a greater amplitude of late positive potential.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04325-6.

The Impact of Data Vulnerability in Online Health Communities: An Institutional Assurance Perspective

In the last few years, online health communities (OHCs) have experienced rapid development due to advances in technology and the COVID-19 pandemic. However, the sensitive nature of medical information has also raised concerns from users about their privacy and reduced their intention to use OHCs. Considering the critical role of data privacy, this study explored the effect of data vulnerability on OHC users. Using online survey data collected from 438 OHC users in China, we found that data vulnerability significantly reduced psychological comfort, while the latter enhanced continuance intention. We also found that psychological comfort negatively mediated the impact of data vulnerability on continuance intention. Institutional assurance approaches, namely privacy policy, privacy protection technology, industry self-regulation, and government legislation, were also found to mitigate the negative impact of data vulnerability on psychological comfort. This study not only contributes to the data privacy, psychological comfort, and institutional assurance literature but also offers suggestions for OHC stakeholders.

The role of collectivism and moderating effect of IT proficiency on intention to disclose protected health information

This paper aims to identify and understand factors affecting insiders’ intention to disclose patients’ medical information and to investigate how these factors affect the intention to disclose. Based on the literature review on deterrence theory and health information security awareness (HISA), we identify relevant factors and develop a research model explaining insiders’ intention to disclose patients’ health information. We collect data (N = 105) through scenario-based experiments. Results show that two personal factors, collectivism, and IT proficiency, play a significant role in the model. While collectivism affects two components (health information security regulation awareness and punishment severity awareness) of HISA which influences intention to disclose, IT proficiency moderates the relationship between HISA and intention to disclose. In addition, HISA negatively affects reporting assessment and intention to disclose. This paper aims to fill a research gap in understanding factors affecting insiders' intentions to disclose protected health information. We identify and investigate factors (e.g., collectivism, HISA, reporting assessment, and IT proficiency) that may affect insiders' disclosing intentions. We find that collectivism affects two components of HISA which influence reporting assessment and disclosing intention. We also discover that IT proficiency moderates the relationship between HISA and intention to disclose. Our findings suggest that we need to carefully consider personal factors such as collectivistic nature and IT proficiency in managing insiders' security breaches.

Patients' Perceptions of Different Information Exchange Mechanisms: An Exploratory Study in the United States

BACKGROUND

Patients may seek health care services from various providers during treatment. These providers could serve in a network (affiliated) or practice separately (unaffiliated). Thus, using secure and reliable health information exchange (HIE) mechanisms would be critical to transfer sensitive personal health information (PHI) across distances. Studying patients' perceptions and opinions about exchange mechanisms could help health care providers build more complete HIEs' databases and develop robust privacy policies, consent processes, and patient education programs.

OBJECTIVES

Due to the exploratory nature of this study, we aim to shed more light on public perspectives (benefits, concerns, and risks) associated with the four data exchange practices in the health care sector.

METHODS

In this study, we compared public perceptions and expectations regarding four common types of exchange mechanisms used in the United States (i.e., traditional, direct, query-based, patient-mediated exchange mechanisms). Traditional is an exchange through fax, paper mailing, or phone calls, direct is a provider-to-provider exchange, query-based is sharing patient data with a central repository, and patient-mediated is an exchange mechanism in which patients can access data and monitor sharing. Data were collected from 1,624 subjects using an online survey to examine the benefits, risks, and concerns associated with the four exchange mechanisms from patients' perspectives.

RESULTS

Findings indicate that several concerns and risks such as privacy concerns, security risks, trust issues, and psychological risks are raised. Besides, multiple benefits such as access to complete information, communication improvement, timely and convenient information sharing, cost-saving, and medical error reduction are highlighted by respondents. Through consideration of all risks and benefits associated with the four exchange mechanisms, the direct HIE mechanism was selected by respondents as the most preferred mechanism of information exchange among providers. More than half of the respondents (56.18%) stated that overall they favored direct exchange over the other mechanisms. 42.70% of respondents expected to be more likely to share their PHI with health care providers who implemented and utilized a direct exchange mechanism. 43.26% of respondents believed that they would support health care providers to leverage a direct HIE mechanism for sharing their PHI with other providers. The results exhibit that individuals expect greater benefits and fewer adverse effects from direct HIE among health care providers. Overall, the general public sentiment is more in favor of direct data transfer. Our results highlight that greater public trust in exchange mechanisms is required, and information privacy and security risks must be addressed before the widespread implementation of such mechanisms.

CONCLUSION

This exploratory study's findings could be interesting for health care providers and HIE policymakers to analyze how consumers perceive the current exchange mechanisms, what concerns should be addressed, and how the exchange mechanisms could be modified to meet consumers' needs.

Big Picture on Privacy Enhancing Technologies in e-Health: A Holistic Personal Privacy Workflow

The collection and processing of personal data offers great opportunities for technological advances, but the accumulation of vast amounts of personal data also increases the risk of misuse for malicious intentions, especially in health care. Therefore, personal data are legally protected, e.g., by the European General Data Protection Regulation (GDPR), which states that individuals must be transparently informed and have the right to take control over the processing of their personal data. In real applications privacy policies are used to fulfill these requirements which can be negotiated via user interfaces. The literature proposes privacy languages as an electronic format for privacy policies while the users privacy preferences are represented by preference languages. However, this is only the beginning of the personal data life-cycle, which also includes the processing of personal data and its transfer to various stakeholders. In this work we define a personal privacy workflow, considering the negotiation of privacy policies, privacy-preserving processing and secondary use of personal data, in context of health care data processing to survey applicable Privacy Enhancing Technologies (PETs) to ensure the individuals’ privacy. Based on a broad literature review we identify open research questions for each step of the workflow.