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The Differing Privacy Concerns Regarding Exchanging Electronic Medical Records of Internet Users in Taiwan

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Abstract

This study explores whether Internet users have different privacy concerns regarding the information contained in electronic medical records (EMRs) according to gender, age, occupation, education, and EMR awareness. Based on the Concern for Information Privacy (CFIP) scale developed by Smith and colleagues in 1996, we conducted an online survey using 15 items in four dimensions, namely, collection, unauthorized access, secondary use, and errors, to investigate Internet users’ concerns regarding the privacy of EMRs under health information exchanges (HIE). We retrieved 213 valid questionnaires. The results indicate that the respondents had substantial privacy concerns regarding EMRs and their educational level and EMR awareness significantly influenced their privacy concerns regarding unauthorized access and secondary use of EMRs. This study recommends that the Taiwanese government organizes a comprehensive EMR awareness campaign, emphasizing unauthorized access and secondary use of EMRs. Additionally, to cultivate the public’s understanding of EMRs, the government should employ various media, especially Internet channels, to promote EMR awareness, thereby enabling the public to accept the concept and use of EMRs. People who are highly educated and have superior EMR awareness should be given a comprehensive explanation of how hospitals protect patients’ EMRs from unauthorized access and secondary use to address their concerns. Thus, the public can comprehend, trust, and accept the use of EMRs, reducing their privacy concerns, which should facilitate the future implementation of HIE.

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References

  1. McGraw, D., Dempsey, J. X., Harris, L., Goldman J., Privacy as an enabler, not an impediment: Building trust into health information exchange. Health Aff. 28:416–427, 2009.

    Article  Google Scholar 

  2. McDonald, C., Protecting patients in health information exchange: A defense of the HIPAA privacy rule. Health Aff. 28:447–449, 2009.

    Article  Google Scholar 

  3. Miller, A. R., Tucker, C. E., Can health care information technology save babies? J Polit Econ 119:289–324, 2011.

    Article  Google Scholar 

  4. Walker, J., Pan, E., Johnston, D., Adler-Milstein, J., Bates, D. W., Middleton, B., The value of health care information exchange and interoperability. Health Aff. w5.10, 2005.

  5. Culnan, M. J., How did they get my name—an exploratory investigation of consumer attitudes toward secondary information use. MIS Quart. 17:341–361, 1993.

    Article  Google Scholar 

  6. Sheehan, K. B., Hoy, M. G., Dimensions of privacy concern among online consumers. J Public Policy Mark 19:62–73, 2000.

    Article  Google Scholar 

  7. Perera, G., Holbrook, A., Thabane, L., Foster, G., Willison, D. J., Views on health information sharing and privacy from primary care practices using electronic medical records. Int J Med Inform 80:94–101, 2011.

    Article  Google Scholar 

  8. Council of Europe, Committee of Ministers 1997. Recommendation No. R (97) 5 on the Protection of Medical Data. Available at: http://www1.umn.edu/humanrts//instree/coerecr97-5.html (Last accessed Oct 25, 2011).

  9. Congress of the United States of America 1996. Health Insurance Portability and Accountability Act. Available at: http://aspe.hhs.gov/admnsimp/pl104191.htm (Last accessed Oct 25, 2011).

  10. Chung, K., Chung, D., Joo, Y., Overview of administrative simplification provisions of HIPAA. J Med Syst 30(1):51–55, 2006.

    Article  Google Scholar 

  11. Rindfleisch, T. C., Privacy, information technology, and health care. Commun ACM 40:92–100, 1997.

    Article  Google Scholar 

  12. Goldman, J., Protecting privacy to improve health care. Health Aff. 17:47–60, 1998.

    Article  Google Scholar 

  13. Williams, P. A., Is the biggest security threat to medical information simply a lack of understanding? Stud Health Technol Inform 168:179–87, 2011.

    Google Scholar 

  14. De Brantes, F., Emery, D. W., Overhage, J. M., Glaser, J., Marchibroda, J., The Potential of HIEs as Infomediaries. Journal of Healthcare Information Management 21: 69–75, 2007.

    Google Scholar 

  15. Chen, J., Yue, Z., Heath, R., An exploratory Investigation of the relationships between consumer characteristics and information privacy. Marketing Management Journal 11: 73–81, 2001.

    Google Scholar 

  16. Phelps, J. E., D’Souza, G., Nowak, G. J., Antecedents and consequences of consumer privacy concerns: An empirical investigation. J Interact Mark 15:2–17, 2001.

    Article  Google Scholar 

  17. Xu, H., Luo, X., Carroll, J. M., Rosson, M. B., The personalization privacy paradox: An exploratory study of decision making process for location-aware marketing. Decis Support Syst 51:42–52, 2011.

    Article  Google Scholar 

  18. Zorotheos, A., Kafeza, E., Users’ perceptions on privacy and their intention to transact online: a study on Greek internet users. Direct Marketing 3:139–153, 2009.

    Article  Google Scholar 

  19. Dinev, T., Bellotto, M., Hart, P., Russo, V., Serra, I., Colautti, C., Privacy calculus model in e-commerce—a study of Italy and the United States. Eur J Inform Syst 15:389–402, 2006.

    Article  Google Scholar 

  20. Tsai, J. Y., Egelman, S., Cranor, L., Acquisti, A., The effect of online privacy information on purchasing behavior: An experimental study. Inform Syst Res 22:254–268, 2011.

    Article  Google Scholar 

  21. Van Slyke, C., Shim, J. T., Johnson, R., Jiang, J. J., Concern for information privacy and online consumer purchasing. Journal of the Association for Information Systems 7:415–44, 2006.

    Google Scholar 

  22. Laric, M. V., Pitta, D. A., Katsanis, L. P., Consumer concerns for healthcare information privacy: a comparison of US and Canadian perspectives. Research in Healthcare Financial Management 2009.

  23. Li, H., Sarathy, R., Xu, H., The role of affect and cognition on online consumers’ decision to disclose personal information to unfamiliar online vendors. Decis Support Syst 51: 434–445, 2011.

    Article  Google Scholar 

  24. Chen, K., Alan, I., Rea, J., Protecting personal information online: A survey of user privacy concerns and control techniques. J Comput Inf Syst 44:85–92, 2004.

    Google Scholar 

  25. Fogel, J., Nehmad, E., Internet social network communities: Risk taking, trust, and privacy concerns. Comput Human Behav 25:153–160, 2009.

    Article  Google Scholar 

  26. Department of Health 2003. Online Health Services Promotion Plan- 2003 Result Report. Available at: http://www.doh.gov.tw/CHT2006/DM/DM2_p01.aspx?class_no=25&now_fod_list_no=9009&level_no=2&doc_no=41589. (Last accessed Oct 25, 2011)

  27. Department of Health 2008. Developing a patient-centered inter-hospital EMR exchange environment. Available at: http://emrstd.doh.gov.tw/strdoc/DocLib/Forms/AllItems.aspx. (Last accessed March 5, 2012).

  28. Department of Health 2012. EMR Standard Management System. Available at: http://emr.doh.gov.tw/exProjects.aspx. (Last accessed March 5, 2012).

  29. Department of Health 2011. Enhanced Intellectual Health Service Plan. Taipei: Department of Health. Available at: http://www.cto.doh.gov.tw/sso/index_c_1.html. (Last accessed Oct 25, 2011)

  30. Hesse, B. W., Nelson, D. E., Kreps, G. L., Croyle, R. T., Arora, N. K., Rimer, B. K., Viswanath, K., Trust and sources of health information: The impact of the internet and its implications for health care providers: Findings from the first health information national trends survey. Arch Intern Med 165:2618–2624, 2005.

    Article  Google Scholar 

  31. Warren, S. D., Brandeis, L. D., The right to privacy. Harv Law Rev 4:193–220, 1890.

    Article  Google Scholar 

  32. Westin, A. F., Science, privacy and freedom: Issues and proposals for the 1970’s. Part I—the impact of surveillance on privacy. Columbia Law Rev 66:1003–1050, 1966.

    Article  Google Scholar 

  33. Culnan, M. J., Bies, R. J., Consumer privacy: Balancing economic and justice considerations. J Soc Issues 59:323–342, 2003.

    Article  Google Scholar 

  34. Boussi, R. H., Solomonides, T., Casassa, M. M., Shiu, S., Rahmouni, M., A model-driven privacy compliance decision support for medical data sharing in Europe. Methods Inf Med 50:326–36, 2011.

    Article  Google Scholar 

  35. Stone, E. F., Gueutal, H. G., Gardner, D. G., McClure, S., A field experiment comparing information-privacy values, beliefs, and attitudes across several types of organizations. J Appl Psychol 68:459–468, 1983.

    Article  Google Scholar 

  36. Huang, C., Lee, H., Lee, D. H., A privacy-strengthened scheme for E-healthcare monitoring system. J Med Syst. Sep 10, 2011.

  37. Adeleke, I. T., Adekanye, A. O., Adefemi, S. A., Onawola, K. A., Okuku, A. G., Sheshi, E. U., James-Adeniran, J. A., Francis, M., Elegbe, T.R., Ayeni, A. M., Tume, A. A., Knowledge, attitudes and practice of confidentiality of patients’ health records among health care professionals at Federal Medical Centre, Bida. Niger J Med 20:228–35, 2011.

    Google Scholar 

  38. Smith, H. J., Milburg, S. J., Burke, S. J., Information privacy: Measuring individuals’ concerns about organizational practices. MIS Quart 20:167–196, 1996.

    Article  Google Scholar 

  39. Stewart, K. A., Segars, A. H., An empirical examination of the concern for information privacy instrument. Inform Syst Res 13:36–49, 2002.

    Article  Google Scholar 

  40. Zhou, T., The impact of privacy concern on user adoption of location-based services. Ind Manage Data Syst 111:212–226, 2011.

    Article  Google Scholar 

  41. Ji, P., Lieber, P. S., Am I safe? Exploring relationships between primary territories and online privacy. Journal of Internet Commerce 9:3–22, 2010.

    Article  Google Scholar 

  42. Phelps, J., Nowak, G., Ferrell, E., Privacy concerns and consumer willingness to provide personal information. J Public Policy Mark 19:27–41, 2000.

    Article  Google Scholar 

  43. Milne, G. R., Culnan, M. J., Strategies for reducing online privacy risks: Why consumers read (or don’t read) online privacy notices. J Interact Mark 18:15–29, 2004.

    Article  Google Scholar 

  44. Janda, S., Fair, L. L., Exploring consumer concerns related to the internet. Journal of Internet Commerce 3:1–21, 2004.

    Article  Google Scholar 

  45. Sheehan, K. B., An investigation of gender differences in on line privacy concerns and resultant behaviors. J Interact Mark 13:24–38, 1999.

    Article  Google Scholar 

  46. Cooper, D. R., Schindler, P. S., Business research methods (Seventh edition). Irwin/McGraw-Hill: New York, 2001:192.

    Google Scholar 

  47. Angst, C. M., Agarwal, R., Adoption of electronic health records in the presence of privacy concerns: The elaboration likelihood model and individual persuasion. MIS Quart 33:339–370, 2009.

    Google Scholar 

  48. Nunnally, J. C., Psychometric theory (First edition). McGraw-Hill: New York, 1967:226

    Google Scholar 

  49. Straub, D., Boudreau, M. C., Gefen, D., Validation guidelines for IS positivist research, Communications of the Association for Information Systems 14:380–426, 2004.

    Google Scholar 

  50. Tee, E. S., Development and promotion of Malaysian dietary guidelines. Asia Pac J Clin Nutr 20:455–461, 2011.

    Google Scholar 

  51. Bonfadelli, H., The internet and knowledge gaps: A theoretical and empirical investigation. Eur J Commun 17:65–84, 2002.

    Article  Google Scholar 

  52. Howard, P. E. N., Rainie, L., Jones, S., Days and nights on the internet-the impact of a diffusing technology. Am Behav Sci 45:382–404, 2001.

    Google Scholar 

  53. Hollingshead, A. B., Four factor index of social status. Yale J Sociol 8: 21–52, 2011.

    Google Scholar 

  54. Meyer, J. W., The effects of education as an institution. Am Journal Sociol 83:55–77, 1977.

    Article  Google Scholar 

  55. Hoy, M. G., Milne, G., Gender differences in privacy-related measures for young adult facebook users. Journal of Interactive Advertising 10:28–45, 2010.

    Google Scholar 

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Disclosure Statement

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Author information

Authors and Affiliations

  1. Institute of Information Management, National Chiao-Tung University, Hsin-Chu City, Taiwan, Republic of China

    Hsin-Ginn Hwang

  2. Institute of Information Management, National Chung-Cheng University, Min-Hsiung, Chia-Yi, Taiwan, Republic of China

    Hwai-En Han

  3. Department of Healthcare Administration, I-Shou University, Yanchao District, Kaohsiung City, Taiwan, Republic of China

    Kuang-Ming Kuo

  4. Department of Information Management, Chia-Nan University of Pharmacy and Science, Jen-Te District, Tainan City, Taiwan, Republic of China

    Chung-Feng Liu

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  1. Hsin-Ginn Hwang
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Correspondence to Kuang-Ming Kuo.

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Hwang, HG., Han, HE., Kuo, KM. et al. The Differing Privacy Concerns Regarding Exchanging Electronic Medical Records of Internet Users in Taiwan. J Med Syst 36, 3783–3793 (2012). https://doi.org/10.1007/s10916-012-9851-1

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  • DOI: https://doi.org/10.1007/s10916-012-9851-1

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