JMIR Publications

ABSTRACT

Background:

In the context of exchange technologies, such as Health Information Exchanges (HIEs), existing technology acceptance theories should be expanded to consider not only the cognitive beliefs resulting in adoption behavior, but also the affect provoked by the sharing nature of the technology.

Objective:

This work uses a trust-centered model to study HIEs adoption. Based on the Theory of Reasoned Action (TRA), the technology adoption literature, and the trust transfer mechanism, we theoretically explain and empirically test the impacts of perceived transparency of privacy policy and trust in healthcare providers on cognitive trust and emotional trust in an HIE. Moreover, we analyze the effects of cognitive trust and emotional trust on the intention to opt in to the HIE and willingness to disclose health information.

Methods:

An online survey was conducted using data from individuals who were aware of HIE through experiences with a (or multiple) provider participating in a HIE network.

Results:

SEM analysis results provide empirical support for the proposed model. Our findings indicate that when patients trust in healthcare providers and they know more about HIE security measures, HIE sharing procedures, and privacy terms, then they feel more in control, more assured, and less at risk. Moreover, trust in providers has a significant moderating effect on building trust in HIE efforts. Results also show that patient trust in HIE may take the forms of opt-in intentions to HIE and patients’ willingness to disclose health information which are exchanged through the HIE.

Conclusions:

The results of this research should be of interest to both academics and practitioners. The findings provide an in-depth dimensions of HIE privacy policy that should be addressed by healthcare organizations to exchange personal health information in a secure and private manner.This work can contribute to trust transfer theory and enrich the literature on HIE efforts. Practitioners can also identify how to leverage the benefit of patients’ trust and trust transfer process to promote HIE initiatives nationwide.