scholarly journals Perspectives of Patients, Health Care Professionals, and Developers Toward Blockchain-Based Health Information Exchange: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Keehyuck Lee ◽  
Kahyun Lim ◽  
Se Young Jung ◽  
Hyerim Ji ◽  
Kyungpyo Hong ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Information ◽  
Health Care Professionals ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Health Management ◽  
The United States ◽  
Record System

BACKGROUND Although the electronic health record system adoption rate has reached 96% in the United States, implementation and usage of health information exchange (HIE) is still lagging behind. Blockchain has come into the spotlight as a technology to solve this problem. However, there have been no studies assessing the perspectives of different stakeholders regarding blockchain-based patient-centered HIE. OBJECTIVE The objective of this study was to analyze the awareness among patients, health care professionals, and information technology developers toward blockchain-based HIE, and compare their different perspectives related to the platform using a qualitative research methodology. METHODS In this qualitative study, we applied grounded theory and the Promoting Action on Research Implementation in the Health Service (PARiHS) framework. We interviewed 7 patients, 7 physicians, and 7 developers, for a total of 21 interviewees. RESULTS Regarding the leakage of health information, the patient group did not have concerns in contrast to the physician and developer groups. Physicians were particularly concerned about the fact that errors in the data cannot be easily fixed due to the nature of blockchain technology. Patients were not against the idea of providing information for clinical trials or research institutions. They wished to be provided with the results of clinical research rather than being compensated for providing data. The developers emphasized that blockchain must be technically mature before it can be applied to the health care scene, and standards of medical information to be exchanged must first be established. CONCLUSIONS The three groups’ perceptions of blockchain were generally positive about the idea of patients having the control of sharing their own health information. However, they were skeptical about the cooperation among various institutions and implementation for data standardization in the establishment process, in addition to how the service will be employed in practice. Taking these factors into consideration during planning, development, and operation of a platform will contribute to establishing practical treatment plans and tracking in a more convenient manner for both patients and physicians. Furthermore, it will help expand the related research and health management industry based on blockchain.

scholarly journals Perspectives of Patients, Health Care Professionals, and Developers Toward Blockchain-Based Health Information Exchange: Qualitative Study

10.2196/18582 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e18582
Author(s):  
Keehyuck Lee ◽  
Kahyun Lim ◽  
Se Young Jung ◽  
Hyerim Ji ◽  
Kyungpyo Hong ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Information ◽  
Health Care Professionals ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Health Management ◽  
The United States ◽  
Record System

Background Although the electronic health record system adoption rate has reached 96% in the United States, implementation and usage of health information exchange (HIE) is still lagging behind. Blockchain has come into the spotlight as a technology to solve this problem. However, there have been no studies assessing the perspectives of different stakeholders regarding blockchain-based patient-centered HIE. Objective The objective of this study was to analyze the awareness among patients, health care professionals, and information technology developers toward blockchain-based HIE, and compare their different perspectives related to the platform using a qualitative research methodology. Methods In this qualitative study, we applied grounded theory and the Promoting Action on Research Implementation in the Health Service (PARiHS) framework. We interviewed 7 patients, 7 physicians, and 7 developers, for a total of 21 interviewees. Results Regarding the leakage of health information, the patient group did not have concerns in contrast to the physician and developer groups. Physicians were particularly concerned about the fact that errors in the data cannot be easily fixed due to the nature of blockchain technology. Patients were not against the idea of providing information for clinical trials or research institutions. They wished to be provided with the results of clinical research rather than being compensated for providing data. The developers emphasized that blockchain must be technically mature before it can be applied to the health care scene, and standards of medical information to be exchanged must first be established. Conclusions The three groups’ perceptions of blockchain were generally positive about the idea of patients having the control of sharing their own health information. However, they were skeptical about the cooperation among various institutions and implementation for data standardization in the establishment process, in addition to how the service will be employed in practice. Taking these factors into consideration during planning, development, and operation of a platform will contribute to establishing practical treatment plans and tracking in a more convenient manner for both patients and physicians. Furthermore, it will help expand the related research and health management industry based on blockchain.

The role of patient engagement in patient-centric health information exchange (HIE) initiatives: an empirical study in the United States

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Pouyan Esmaeilzadeh ◽  
Spurthy Dharanikota ◽  
Tala Mirzaei
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
The United States ◽  
Willingness To Participate ◽  
Healthcare Organizations ◽  
Content Type ◽  
Patient Centric

PurposePatient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.Design/methodology/approachThe authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).FindingsThe proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.Originality/valueThe authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

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

2020 ◽  
Vol 59 (04/05) ◽  
pp. 162-178
Author(s):  
Pouyan Esmaeilzadeh
Keyword(s):  
United States ◽  
Health Care ◽  
Health Information ◽  
Health Care Providers ◽  
Information Exchange ◽  
The United States ◽  
Exchange Mechanism ◽  
Care Providers ◽  
Security Risks ◽  
Direct Exchange

Abstract 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.

Eliciting nurses’ perspectives to improve health information exchange between hospital and home health care

2019 ◽  
Vol 40 (3) ◽  
pp. 277-283 ◽  
Author(s):  
Erin Sarzynski ◽  
Mark Ensberg ◽  
Amy Parkinson ◽  
Laurie Fitzpatrick ◽  
Laura Houdeshell ◽  
...  
Keyword(s):  
Health Care ◽  
Health Information ◽  
Home Health Care ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Home Health ◽  
Improve Health

scholarly journals Bridging Organizational Divides in Health Care: An Ecological View of Health Information Exchange

2013 ◽  
Vol 1 (1) ◽  
pp. e3 ◽  
Author(s):  
Kim M Unertl ◽  
Kevin B Johnson ◽  
Cynthia S Gadd ◽  
Nancy M Lorenzi
Keyword(s):  
Health Care ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Ecological View

Florida Health Information Exchange

2013 ◽  
pp. 152-170
Author(s):  
Alice Noblin ◽  
Kelly McLendon ◽  
Steven Shim
Keyword(s):  
Health Care ◽  
Information Sharing ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Care Industry ◽  
Privacy And Security ◽  
Care Industry ◽  
Basic Services ◽  
Security Regulations

Florida began the journey to health information connectivity in 2004 under Governor Jeb Bush. Initially these efforts were funded by grants, but due to the downturn in the economy, the state was unable to support growth in 2008. The American Recovery and Reinvestment Act of 2009 provided funding to further expand health information exchange efforts across the country. As a result, Florida is now able to move forward and make progress in information sharing. Harris Corporation was contracted to provide some basic services to the health care industry in 2011. However, challenges remain as privacy and security regulations are put in place to protect patients’ information. With two seemingly opposing mandates, sharing the information versus protecting the information, challenges continue to impede progress.

Missing Link of the Health Information Exchange Loop

2017 ◽  
pp. 1185-1196
Author(s):  
Alice Noblin ◽  
Kendall Cortelyou-Ward
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Medical Data ◽  
Patient Portals ◽  
Record Keeping ◽  
Care Industry ◽  
Basic Services

Since 2004, the services of the Florida Health Information Exchange (HIE) have grown, and in 2011, the state contracted with Harris Corporation to provide some basic services to the Florida health care industry and provide functional improvements to the expanding state-wide HIE. The endeavors of this public-private partnership continue to the present day; however, as HIE services have expanded, challenges continue to be encountered. Ultimately, successful exchange of medical data requires patient engagement and “buy-in.” The purpose of this article will consider why patient engagement is important for HIE success, offer recommendations to improve both patient and provider interest, and consider the importance of online patient portals to increase the effectiveness of health record keeping and the sharing of vital patient medical information needed by caregivers and their patients.

Regional and Community Health Information Exchange in the United States

2011 ◽  
pp. 198-218 ◽  
Author(s):  
Adi V. Gundlapalli ◽  
Jonathan H. Reid ◽  
Jan Root ◽  
Wu Xu
Keyword(s):  
United States ◽  
Patient Care ◽  
Community Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Business Case ◽  
The United States ◽  
Healthcare Systems ◽  
Secure Information

A fundamental premise of continuity in patient care and safety suggests timely sharing of health information among different providers at the point of care and after the visit. In most healthcare systems, this is achieved through exchange of written medical information, phone calls and conversations. In an ideal world, this exchange of health information between disparate providers, healthcare systems, laboratories, pharmacies and payers would be achieved electronically and seamlessly. The potential benefits of electronic health exchange are improved patient care, increased efficiency of the healthcare system and decreased costs. The reality is that health information is electronically exchanged only to a limited extent within local communities and regions, much less nationally and internationally. One main challenge has been the inability of health information exchange organizations to develop a solid business case. Other challenges have been socio-political in that data ownership and stewardship have not been clearly resolved. Technological improvements over the past 20 years have provided significant advances towards safe and secure information exchange. This chapter provides a general overview of community health information exchange in the United States of America, its history and details of challenges faced by stakeholders. The lessons learned from successes and failures, research and knowledge gaps and future prospects are also discussed. Current and future technologies to facilitate and invigorate health information exchange are highlighted. Two examples of successful regional health information exchanges in the US states of Utah and Indiana are highlighted.

Weathering the Storm

2016 ◽  
Vol 4 (2) ◽  
pp. 53-61
Author(s):  
Alice M. Noblin ◽  
Kendall Cortelyou-Ward ◽  
Ashley Rutherford
Keyword(s):  
Health Care ◽  
Health Information ◽  
Disaster Preparedness ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Care Industry ◽  
Care Industry ◽  
Basic Services ◽  
Technology Initiatives ◽  
Network Of Networks

The Florida Health Information Exchange has grown over the years since its inception in 2004. Harris Corporation was contracted to provide some basic services to the health care industry in 2011 and this relationship has continued to the present time. As services have expanded, challenges have arisen. With disaster preparedness and business continuity an important part of continuity of care and health information technology initiatives, this paper will consider how a “network of networks” can be of assistance when natural disasters strike.

A Viewpoint of Security for Digital Health Care in the United States

2014 ◽  
Vol 2 (1) ◽  
pp. 1-21 ◽  
Author(s):  
Steven A. Demurjian ◽  
Alberto De la Rosa Algarín ◽  
Jinbo Bi ◽  
Solomon Berhe ◽  
Thomas Agresta ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Information ◽  
Information Exchange ◽  
Digital Health ◽  
The United States ◽  
Hard Copy ◽  
Health Providers ◽  
Patient Portals ◽  
Health Records

In health care, patient information of interest to health providers, researchers, public health researchers, insurers, patients, etc., is stored in different locations via electronic media and/or hard-copy formats. All potential users need electronic access to health information technology systems such as: electronic health records, personal health records, patient portals, and ancillary systems such as imaging, laboratory, pharmacy, etc. Controlling access to information from multiple systems requires granularity levels of privileges ranging from one patient to a cohort to an entire population. In this paper, we present a viewpoint of the state of secure digital health care in the United States, focusing on the resources that need to be protected as dictated by legal entities and regulations, the available approaches in the present state-of-the art, and, the potential needs for the future of security for digital health care. By utilizing a real world scenario, the authors explore the limitations of health information exchange in the United States, and present one possible architecture for secure digital health care that builds on existing technology alternatives.

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