The often lengthy preparatory processes ended up serving as a crucial component of early success, because it allowed sites to address concerns, educate stakeholders about design choices, and build trust and support for system implementation. Without these processes, it is likely that stakeholder perspectives may have been very different. HIE acceptability may depend on preexisting trust among patients, providers, and institutions. In our data, patient trust of the systems appeared to be driven in part by the confidence they already held in their providers and care facilities.
It would be particularly relevant to examine these issues with patients from communities that are likely to still be suspicious of or fear data sharing. Although stigma against HIV itself has declined [ 51 ], legal sanctions and social norms still may influence some populations affected by the disease [ 56 ]. For example, publicly funded clinical settings provide critical safety net health coverage to undocumented workers who, because of the fear of deportation, may be far more hesitant to seek care if information about them were to be shared across regional health networks and government agencies, such as health departments.
Our patient survey data did not permit us to test those hypotheses because the present study was not powered to detect attitudinal differences in patient subgroups.
Further research will be needed to determine whether there are indeed specific groups of patients who are reluctant to share their personal health data electronically. Stakeholder perspectives were derived by the trust they placed in their collaborating HIE partners. The process of collaboration helped to leverage resources, providing opportunities for smaller agencies to benefit from the technical expertise and support provided by the IT staff affiliated with a HIE.
Smaller agencies also received legal advice and health information systems capacity-building that they otherwise would not have been able to afford. In this sense, the HIEs helped to distribute resources more evenly across agencies and to enhance, access to technologies that could help address unmet needs.
Clinical environments should not anticipate easy implementation of information exchanges if there is existing distrust between patients and providers, or if partnering agencies have historically been suspicious of one another.
Efforts must be made to forge common bonds before directing resources to setting up the technological infrastructures required for data exchange. Addressing attitudes on trust and confidentiality of sharing patient data electronically will influence the perceived usefulness, the perceived ease of use, and adoption of HIE. Gaining stakeholders and patients trust in the security and confidentiality of the data is absolutely essential when designing and implementing HIEs.
Our findings suggest that confidentiality concerns related to sharing data electronically will not be barriers to HIEs becoming integrated into patient care, at least among the general population of patients and providers in publicly funded clinics. Rather, the perception that the HIEs cause no harm and may in fact benefit patients and other stakeholders is likely to influence their use and acceptability.
Nevertheless, the question remains whether human error or a breach in confidentiality, whether as part of the HIEs or a highly publicized event in the field of technological communication or online information exchange, may emerge to affect the expected benefits and the trust in the HIEs. Furthermore, acceptability and trust in the safety of personal information shared through HIEs may influence future policy issues, laws, and privacy rules related to a healthcare system and industry driven by new and ever changing technologies and electronic communication [ 57 — 60 ].
Our study has several limitations. First, the data were collected exclusively in public settings. Stakeholder attitudes may differ in other care environments. However, it is worth noting that the majority of HIV patients in care in the US currently receive services through at least one publicly-supported program e. Second, the data are focused on efforts pre-implementation of the HIEs. Thus, they speak to the processes of building stakeholder trust and buy-in, but do not reflect on satisfaction or efficacy of the systems once in use.
Third, the data collected with patients was limited to quantitative surveys. In collaboration with the six HIE sites and based on our resources, we decided not to include patients in the qualitative sample. Interviewing them pre-implementation may not have yielded much specific information, but rather more potential scenarios, about the HIEs they were not familiar with.
Providers were able to offer insights into some of the factors that likely affect patient attitudes. Given the many parallels between provider and patient attitudes and given that patients learn much of their information about systems from providers; we believe that those provider insights are relevant.
Similarly, it is beyond the purpose of this paper to examine specific concerns of groups of patients. However, our patient quantitative data do not seem to indicate a difference according to ethnicity, gender, or sexual orientation in relationship to data sharing. Fourth, we did not interview institutional leaders outside the projects, who were more distal players within the partnering institutions. That was not part of our work, as we were tasked with evaluating the specific projects. Thus, we are not representing their personal opinions, but rather the institutional responses to the proposed projects based on the perceptions of project staff and providers.
They offered good insights into the kinds of barriers at the institutional level, but those reports may not offer the same degree of nuance that would be found by interviewing those distal players. They may help improve coordination and efficiency of care across medical clinics, support service agencies, payers, and public health entities.
Providers and other stakeholders are willing to accept new technologies to promote more rapid and effective data sharing even when care involves a disease that historically has been seen as highly stigmatized. However, this acceptability appears to be dependent on the time and effort expended to understand and address potential concerns related to data sharing and confidentiality, and to fully educate and build trust among stakeholders about the nature of the new systems and how they will be used.
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The enjoyment of these standards at the highest levels is a basic human right that should be accessible by each and every worker. This research will explore the dynamics of that relationship and attempt to find correlating factors that may contribute to the success of an organization. The Data collected may be passed onto interested parties but this must be only the appropriate information.
Schools hold lots of information about pupils, staff and parents. Confidentiality A key component for relationship building and sustaining relationships is confidentiality.
Confidentiality in any workplace is of utmost importance. It is an important right for every individual. Confidentiality creates trust, respect and shows sensitivity.
These qualities are especially important in school as parents, staff and children need to feel safe and secure. Safety and security can only occur where trust, respect and sensitivity are present. If this happens to you, never automatically promise confidentiality. Let the person know if the information they share violates company policy, is illegal, or is possibly putting someone in danger, then you might be forced to break confidentiality. This tactic turns a no-win situation into a somewhat better situation in which that person must now carefully decide what to do with their secret.
Avoid chronic offenders. This may mean walking away from groups of people when they start bashing others behind their back. When it comes to such chronic offenders, a good rule of thumb is to avoid them if you can, confront them if you must. Business Management, A. Business Administration, B. Medical Assistant, A. Medical Billing and Coding, A. Nursing, A. Health Care Administration, B.
Cybersecurity, A. Computer Information Systems, B. Programs Programs Overview. Degree completion A. Associate of Applied Science B. Bachelor of Science.
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