The impacts of the privacy policy on individual trust in health information exchanges (HIEs)

Abstract

PurposeHealth information exchange (HIE) initiatives utilize sharing mechanisms through which health information is mostly transmitted without a patient's close supervision; thus, patient trust in the HIE is the core in this setting. Existing technology acceptance theories mainly consider cognitive beliefs resulting in adoption behavior. The study argues that existing theories should be expanded to cover not only cognitive beliefs but also the emotion provoked by the sharing nature of the technology. Based on the theory of reasoned action, the technology adoption literature, and the trust literature, we theoretically explain and empirically test the impact of perceived transparency of privacy policy on cognitive trust and emotional trust in HIEs. Moreover, the study analyzes the effects of cognitive trust and emotional trust on the intention to opt in to HIEs and willingness to disclose health information.Design/methodology/approachAn online survey was conducted using data from individuals who were aware of HIEs through experience with at least one provider participating in an HIE network. Data were collected from a wide range of adult population groups in the United States.FindingsThe structural equation modeling analysis results provide empirical support for the proposed model. The model highlights the strategic role of the perceived transparency of the privacy policy in building trust in HIEs. When patients know more about HIE security measures, sharing procedures, and privacy terms, they feel more in control, more assured, and less at risk. The results also show that patient trust in HIEs may take the forms of intention to opt in to an HIE and willingness to disclose health information exchanged through HIE networks.Originality/valueThe findings of this study should be of interest to both academics and practitioners. The research highlights the importance of developing and using a transparent privacy policy in the diffusion of HIEs. The findings provide a deep understanding of dimensions of HIE privacy policy that should be addressed by health-care organizations to exchange personal health information in a secure and private manner.