A cross-sectional survey exploring attitudes towards provincial electronic health record implementation among clients attending the Provincial Sexually Transmitted Infections Clinic in British Columbia

Patient and Public Willingness to Share Personal Health Data for Third-Party or Secondary Uses: Systematic Review

BACKGROUND

International advances in information communication, eHealth, and other digital health technologies have led to significant expansions in the collection and analysis of personal health data. However, following a series of high-profile data sharing scandals and the emergence of COVID-19, critical exploration of public willingness to share personal health data remains limited, particularly for third-party or secondary uses.

OBJECTIVE

This systematic review aims to explore factors that affect public willingness to share personal health data for third-party or secondary uses.

METHODS

A systematic search of 6 databases (MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and SocINDEX) was conducted with review findings analyzed using inductive-thematic analysis and synthesized using a narrative approach.

RESULTS

Of the 13,949 papers identified, 135 were included. Factors most commonly identified as a barrier to data sharing from a public perspective included data privacy, security, and management concerns. Other factors found to influence willingness to share personal health data included the type of data being collected (ie, perceived sensitivity); the type of user requesting their data to be shared, including their perceived motivation, profit prioritization, and ability to directly impact patient care; trust in the data user, as well as in associated processes, often established through individual choice and control over what data are shared with whom, when, and for how long, supported by appropriate models of dynamic consent; the presence of a feedback loop; and clearly articulated benefits or issue relevance including valued incentivization and compensation at both an individual and collective or societal level.

CONCLUSIONS

There is general, yet conditional public support for sharing personal health data for third-party or secondary use. Clarity, transparency, and individual control over who has access to what data, when, and for how long are widely regarded as essential prerequisites for public data sharing support. Individual levels of control and choice need to operate within the auspices of assured data privacy and security processes, underpinned by dynamic and responsive models of consent that prioritize individual or collective benefits over and above commercial gain. Failure to understand, design, and refine data sharing approaches in response to changeable patient preferences will only jeopardize the tangible benefits of data sharing practices being fully realized.

Factors Affecting Willingness on Sharing of Electronic Health Records Data: A Survey on Chinese Residents

Background

China has been promoting sharing of Electronic Health Records (EHRs) data for several years. However, only a few studies have explored the views of Chinese residents on sharing personal health data, and the factors that affect sharing of EHRs have not been fully elucidated. This study sought to explore public attitudes toward sharing EHRs and the factors that affect sharing of personal health data among Chinese residents.

Methods

A multi-stage stratified sampling design was adopted in this survey to select residents in Hunan province, resulting in 932 responses randomly. The investigation was carried out with the administration of a 19-item questionnaire. The measure includes items on demographics, willingness to share EHRs, experiences on EHRs, public acknowledgment of the benefits of sharing EHRs, and public awareness of potential risks of sharing EHRs.

Results

The score of general willingness to share EHRs was 5.784 ± 2.031. Concerning the domain scores for the willingness, the willingness to share EHRs for research was 2.060 ± 0.942, whereas sharing anonymization EHRs for other nonmedical services was only 1.805 ± 0.877. Multiple linear regression showed that general willingness to share EHRs was related to job-related healthcare (β = 0.520), experiences on EHRs (β = 0.192), public awareness of potential risks of sharing EHRs (β = −0.130), and public acknowledgment of the benefits of sharing EHRs (β = 0.290).

Conclusion

The willingness to share EHRs data with Chinese residents was not high. The willingness of Chinese residents towards data sharing in EHRs is influenced by several factors, primarily job-related to healthcare, experiences on EHRs, public acknowledgment of the benefits of sharing EHRs, and public awareness of potential risks of sharing EHRs. The results provide a basis for related research and provide information for designing public health strategies such as formulating policies to improve public acceptance of sharing EHRs and promoting EHRs-based public health services.

Factors Associated With Willingness to Share Health Information: Rapid Review

Background

To expand research and strategies to prevent disease, comprehensive and real-time data are essential. Health data are increasingly available from platforms such as pharmaceuticals, genomics, health care imaging, medical procedures, wearable devices, and internet activity. Further, health data are integrated with an individual’s sociodemographic information, medical conditions, genetics, treatments, and health care. Ultimately, health information generation and flow are controlled by the patient or participant; however, there is a lack of understanding about the factors that influence willingness to share health information. A synthesis of the current literature on the multifactorial nature of health information sharing preferences is required to understand health information exchange.

Objective

The objectives of this review are to identify peer-reviewed literature that reported factors associated with health information sharing and to organize factors into cohesive themes and present a narrative synthesis of factors related to willingness to share health information.

Methods

This review uses a rapid review methodology to gather literature regarding willingness to share health information within the context of eHealth, which includes electronic health records, personal health records, mobile health information, general health information, or information on social determinants of health. MEDLINE and Google Scholar were searched using keywords such as electronic health records AND data sharing OR sharing preference OR willingness to share. The search was limited to any population that excluded health care workers or practitioners, and the participants aged ≥18 years within the US or Canadian context. The data abstraction process using thematic analysis where any factors associated with sharing health information were highlighted and coded inductively within each article. On the basis of shared meaning, the coded factors were collated into major themes.

Results

A total of 26 research articles met our inclusion criteria and were included in the qualitative analysis. The inductive thematic coding process revealed multiple major themes related to sharing health information.

Conclusions

This review emphasized the importance of data generators’ viewpoints and the complex systems of factors that shape their decision to share health information. The themes explored in this study emphasize the importance of trust at multiple levels to develop effective information exchange partnerships. In the case of improving precision health care, addressing the factors presented here that influence willingness to share information can improve sharing capacity for individuals and allow researchers to reorient their methods to address hesitation in sharing health information.

Putting the Patient First: A Scoping Review of Patient Desires in Canada

Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Five broad themes were identified and expressed differently across the health states, including personalized care, navigation, choice, holistic care and care continuity. Patients' perspectives must be considered to meet the diverse needs of targeted patient groups, which can inform health system planning, quality improvement initiatives and targeting of investments.

High uptake of shared electronic health records among HIV-infected patients at an Australian sexual health clinic

The uptake of an opt-in system for integrating the health information of HIV-infected patients of an Australian sexual health clinic into the regional shared electronic health record (EHR) is described. A medical record audit was performed to determine the number and demographic characteristics of HIV-infected patients in the study's sexual health clinic opting in and out of inclusion in the regional shared EHR. The majority of these HIV-infected patients (70%, 95% CI: 58-79%) took up the option of including their HIV-related records into the regional shared electronic health record.