Privacy, confidentiality, security and patient safety concerns about electronic health records

Abstract

Aims: This study explored concerns among nurses working in the United Arab Emirates associated with the use of electronic health records, including privacy, confidentiality, security and patient safety.

Background: Given the widespread implementation of electronic health records, there are concerns about data integrity that could jeopardize healthcare quality. Addressing nurses' concerns about data integrity and safety is critical to inform health policies and promote public trust.

Methods: Nurses working in healthcare settings in the United Arab Emirates (N = 562) were invited to share their concerns about data integrity and patient safety using a mixed-method approach. Data were collected between January and June 2018 via questionnaires and focus group interviews. Following a survey of nurses' concerns about privacy, confidentiality, security and patient safety in electronic health records, six focus groups were held to gain deeper insights about their concerns. Major themes that emerged from the focus groups were extracted to align with the main sections of the questionnaire.

Results: Nurses expressed concern over the security of electronic health records (n = 270, 48%). Administrative-related security, inadequate training and access by unauthorized users were the most frequently reported concerns. The main patient safety concerns were associated with non-technological factors, including lack of audit by staff, poor communication with technology vendors and length of time required for documentation. The focus group results reflected similar issues, with an additional theme being inconsistency in data integrity policies.

Conclusions and implications for nursing/health policy: Frontline nurse managers need to integrate pragmatic policies to support staff compliance with the code of ethics when using online data. Nurses must follow workplace policies that foster reporting of risks to online incident systems to ensure data integrity. A unified health policy based on multidisciplinary partnership is critical to safeguard online data and promote public trust.

Keywords: Code of ethics; Confidentiality; Data Integrity; Electronic Health Records; Health Policy; Nursing Policy; Patient Safety; Privacy; Security; United Arab Emirates.