How private are the electronic health records? Family physicians’ perspectives towards electronic health records privacy
Keywords:Ethical issues; Electronic health records; Privacy; Physicians perceptions; Saudi Arabia
Background: The study intended to measure the family physicians’ perspectives towards electronic health records (EHR) privacy and explore the factors determining these perceptions.
Methods: All the primary care physicians were invited to participate in the online survey using a validated Health Information Privacy Questionnaire (HIPQ). Four themes were evaluated - (i) ability of computers to keep health information private (ii) accessibility to outsiders use (iii) sharing of health information with other health professionals and (iv) benefits versus risk of computerized health information. Descriptive statistics were reported for categorical and continuous data while student-t test and ANOVA were used to quantify association.
Results: Majority perceived EHR to be more private than the paper-based records while some disagreed and expressed concern about data leakage. Senior physicians (p=0.05), non-Saudi’s (p=0.029) and consultants (p= 0.004) well perceived the privacy of computerized information. Many physicians agreed to sharing of data with the Ministry of Health (53/89; 59.6%) and hospital-based research centers (49/89;55%) but did not favor data accessibility and sharing with insurance and pharmaceutical companies. Most of the respondents (48/89;54%) disagreed to the risk of possible loss of confidentiality using EHR. Higher age (p=0.018) and consultant rank (p=0.024) were strong predictors of higher scores for overall benefits of EHR and its usefulness in healthcare delivery planning.
Conclusion: The EHR does not compromise the privacy, safety and confidentiality of patient health data. The physicians acknowledged the perceived usefulness of e-health systems and advocate its implementation in larger hospitals across Saudi Arabia. However, there is a need to devise multiple strategies to prevent data leakage and breach in confidentiality by non-hospital sources.
Hayrinen K, Saranto K, Nykanen P. Definition, Structure, Content, Use and Impacts of Electronic Health Records: A Review of the Research Literature. Int J Med Inform. 2008;77(5):291 - 304.
Lipschutz JH. Electronic health records in hospitals. N Engl J Med. 361. United States2009. p. 421; author reply 2.
Mueller JT, Trentman TL. Electronic health records in hospitals. N Engl J Med. 2009;361(4):421; author reply 2.
Gans D, Kralewski J, Hammons T, Dowd B. Medical groups' adoption of electronic health records and information systems. Health Aff (Millwood). 2005;24(5):1323-33.
McCarthy M. Use of electronic medical records expands in the US, but some hospitals are trailing. Bmj. 2013;347:f4516.
Classen DC, Holmgren AJ, Co Z, Newmark LP, Seger D, Danforth M, et al. National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018. JAMA Netw Open. 2020;3(5):e205547.
Black AD, Car J, Pagliari C, Anandan C, Cresswell K, Bokun T, et al. The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med. 2011;8(1):e1000387.
Lau F, Price M, Boyd J, Partridge C, Bell H, Raworth R. Impact of electronic medical record on physician practice in office settings: a systematic review. BMC Med Inform Decis Mak. 2012;12:10.
Schopf TR, Nedrebø B, Hufthammer KO, Daphu IK, Lærum H. How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC Health Serv Res. 2019;19(1):934.
Altuwaijri MM. Electronic-health in Saudi Arabia. Just around the corner? Saudi Med J. 2008;29(2):171-8.
Jabali AK. Progress in adopting EHR in Saudi eastern region private hospitals. International Journal of Healthcare Management. 2017;10(1):13-8.
Medical City King Saud University. About King Saud University- Medical City 2020 [cited 2020 21 August]. Available from: https://medicalcity.ksu.edu.sa/en/page/about-ksumc.
Perera G, Holbrook A, Thabane L, Foster G, Willison DJ. Views on health information sharing and privacy from primary care practices using electronic medical records. Int J Med Inform. 2011;80(2):94-101.
McGinn CA, Gagnon, M., Shaw, N, et al. Users’ perspectives of key factors to implementing electronic health records in Canada: a Delphi study. BMC Med Inform Decis Ma. 2012;12.
Anderson JG. Social, ethical and legal barriers to e-health. Int J Med Inform. 2007;76(5-6):480-3.
Krist AH, Beasley JW, Crosson JC, Kibbe DC, Klinkman MS, Lehmann CU, et al. Electronic health record functionality needed to better support primary care. J Am Med Inform Assoc. 2014;21(5):764-71.
Al-Fawzan N EO. Data protecion in the Kingdom of Saudi Arabia: A Primer. Available from: https://www.lw.com/presentations/Data-Protection-in-the-Kingdom-of-Saudi-Arabia.
Osborne C. The latest healthcare data breaches in 2019/2020. Cybersecurity news and views [Internet]. 2020. Available from: https://portswigger.net/daily-swig/the-latest-healthcare-data-breaches.
Fernández-Alemán JL, Señor IC, Lozoya P, Toval A. Security and privacy in electronic health records: a systematic literature review. J Biomed Inform. 2013;46(3):541-62.
Rezaeibagha F, Win KT, Susilo W. A systematic literature review on security and privacy of electronic health record systems: technical perspectives. Health Inf Manag. 2015;44(3):23-38.
Demuynck L. DDB. Privacy-Preserving Electronic Health Records. Preserving Electronic Health Records In: Dittmann J, Katzenbeisser S, Uhl A (eds) Communications and Multimedia Security CMS 2005 Lecture Notes in Computer Science, vol 3677 Springer, Berlin, Heidelberg2005.
Alzobaidi H ZE, Sadeq B , Alghamdi AR , Ahmed ET. Attitudes toward implementing electronic medical record among Saudi physicians. 2016;5(6):1244-55.
Loomis GA, Ries JS, Saywell RM, Jr., Thakker NR. If electronic medical records are so great, why aren't family physicians using them? J Fam Pract. 2002;51(7):636-41.
Russell SC, Spooner SA. Barriers to EMR adoption in internal medicine and pediatric outpatient practices. Tenn Med. 2004;97(10):457-60.
Kho AN, Cashy JP, Jackson KL, Pah AR, Goel S, Boehnke J, et al. Design and implementation of a privacy preserving electronic health record linkage tool in Chicago. J Am Med Inform Assoc. 2015;22(5):1072-80.
Bah S, Alharthi H, El Mahalli AA, Jabali A, Al-Qahtani M, Al-kahtani N. Annual survey on the level and extent of usage of electronic health records in government-related hospitals in Eastern Province, Saudi Arabia. Perspect Health Inf Manag. 2011;8(Fall):1b.
Alanazi B, Butler-Henderson K, Alanazi M. Perceptions of healthcare professionals about the adoption and use of EHR in Gulf Cooperation Council countries: a systematic review. BMJ Health Care Inform. 2020;27(1).
Darr A, Harrison MI, Shakked L, Shalom N. Physicians' and nurses' reactions to electronic medical records. Managerial and occupational implications. Journal of health organization and management. 2003;17(5):349-59.
Alasmary M, El Metwally A, Househ M. The Association between Computer Literacy and Training on Clinical Productivity and User Satisfaction in Using the Electronic Medical Record in Saudi Arabia. Journal of Medical Systems. 2014;38(8).
How to Cite
Copyright (c) 2021 Journal of Health Informatics in Developing Countries
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.Authors retain copyright of the submission while granting the journal the right to publish it in the journal and in print.