Do personal health concerns and trust in healthcare providers mitigate privacy concerns? Effects on patients' intention to share personal health data on electronic health records

Abstract

Rationale: 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.

Objective: 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.

Method: 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.

Results: 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.

Conclusions: 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.

Keywords: Electronic health record; France; Health digitalization; Intention to share personal health-data; Personal health concerns; Privacy calculus; Privacy concerns; Trust.