Trust in Patient-Centered E-Health

Trust in Patient-Centered E-Health

Richard Klein (Clemson University, USA)
Copyright: © 2009 |Pages: 17
DOI: 10.4018/978-1-60566-016-5.ch008
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Abstract

Patient-centered e-health (PCEH) offerings see the emergence of divergent, new third parties, through initiatives, including (a) medical content aggregation, (b) health-based online communities, and (c) patient-physician Internet-based portals. Here, the product is digital and heterogeneous for medical content aggregators; virtual and heterogeneous for online communities; and digital, context-specific, and asynchronous for patient-physician portals. With patients expressing privacy and confidentiality concerns in communicating personal health information electronically, growing numbers of PCEH initiatives give rise to many unique issues with respect to patient trust. Existing electronic commerce research focuses on trust in online vendors, potentially providing an incomplete picture with respect to patient trust in PCEH. An accurate and holistic understanding of patient trust encompasses different combinations of cognitive processes, disposition to trust, and institution-based trust, all shaping trusting
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Introduction

E-health encompasses “the use of emerging information and communication technology, especially the Internet, to improve or enable health and healthcare” (Eng, 2001, pp.20). Surveys estimate that 40% of Internet users go online to obtain medical information (Baker, Wagner, Singer, & Bundorf, 2003). Accordingly, Internet-focused firms, such as WebMD (http://www.WebMD.com/), are among the fastest growing in the healthcare industry (Wareham & Klein, 2003). Vendors have developed and subsequently deployed Internet-based IT innovations increasingly aimed at patients and their caregivers (Eudes, 2006). The growing use of the Internet within this industry gives rise to many unique and emerging issues with respect to patient trust.

Patient-centered e-health (PCEH) offerings see the emergence of divergent, new third parties, through initiatives including (a) medical content aggregation, (b) health-based online communities, and (c) patient-physician Internet-based portals. Here, the product is digital and heterogeneous for medical content aggregators; virtual and heterogeneous for online communities; and digital, context specific, and asynchronous for patient-physician portals. With patients expressing privacy and confidentiality concerns in communicating personal health information electronically, growing numbers of PCEH initiatives give rise to many unique issues with respect to patient trust. Existing electronic commerce research focuses on trust in online vendors, potentially providing an incomplete picture with respect to patient trust in PCEH. An accurate and holistic understanding of patient trust encompasses different combinations of cognitive processes, disposition to trust, and institution-based trust, all shaping trusting beliefs in these

Consider that within the United States, the debate over national electronic health records has cited concerns with privacy and confidentiality (Dixon, 2007). Patients have expressed similar privacy and confidentiality concerns in communicating personal health information electronically (Bernhardt, Lariscy, Parrott, Silk, & Felter, 2002; Hassol, Walker, Kidder, Rokita, Young, Pierdon, Deitz, Kuck, & Ortiz, 2004). Accordingly, patient trust emerges as a complex issue with respect to growing uses of the Internet and Internet-based technologies. Furthermore, patient trust constitutes a critical success factor for patient-centered e-health (PCEH) initiatives, including (a) medical content aggregators, (b) health-based online communities, and (c) patient-physician Net-based portals, noted in Figure 1. As more patients turn to the Internet in managing their medical conditions; healthcare providers, medical content aggregators, as well as Internet-based solution vendors must understand the factors that affect patient trust with respect to different trustee constituencies.

Figure 1.

Patient-centered e-health initiatives

In years past, trust has been perceived as a traditional and simple patient-physician dyad. This trust still exists in face-to-face environments such as doctors’ offices and hospitals. However, with the addition of multiple third parties in Internet-based environments, the potential exists for divergent levels of trust and for different constituencies to influence actions.

Medical content aggregators, such as Dr. Koop (http://www.drkoop.com/), must garner the trust of patients in order for their services to provide value, promoting use that ultimately translates into greater performance through advertising revenues and/or subscription fees. Additionally, patients must trust the author of the content provided. If patients do not have the requisite trust in the source of the content, it will likely go unused as patients turn to alternate outlets.

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Table of Contents
Foreword
Joseph Tan
Acknowledgment
E. Vance Wilson
Chapter 1
Juanita Dawson, Bengisu Tulu, Thomas A. Horan
This chapter provides a conceptual foundation by exploring the existing literature on traditional healthcare, patient-centered healthcare, and the... Sample PDF
Towards Patient-Centered Care: The Role of E-Health in Enabling Patient Access to Health Information
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Chapter 2
Alejandro Mauro
This chapter introduces a series of techniques and tools useful for developing patient-centered e-health. As information technology (IT) is... Sample PDF
Patient-Centered E-Health Design
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Chapter 3
Jan-Are K. Johnsen
In this chapter, we look at some fundamental aspects of communicating about ourselves and our health through technology. In particular, we examine... Sample PDF
Connecting with Ourselves and Others Online: Psychological Aspects of Online Health Communication
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Chapter 4
Ebrahim Randeree
An increasing focus on e-health and a governmental push to improve healthcare quality while giving patients more control of their health data have... Sample PDF
Personal Health Records: Patients in Control
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Chapter 5
Elaine A. Blechman
Newly disabled workers are often unemployed, uninsured, and indigent. They are in desperate need of Social Security OASDI monthly benefits, and the... Sample PDF
Disability Determinations and Personal Health Records
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Chapter 6
E-Health Marketing  (pages 70-80)
Muhammad F. Walji, John A. Valenza, Jiajie Zhang
In this chapter, we review key concepts, using the marketing mix framework, to identify the needs of healthcare consumers, and the tools and... Sample PDF
E-Health Marketing
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Chapter 7
Olli P. Järvinen
This chapter introduces the privacy management framework as a means of studying patient-centered e-health. The chapter raises some important issues... Sample PDF
Privacy Management of Patient-Centered E-Health
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Chapter 8
Richard Klein
Patient-centered e-health (PCEH) offerings see the emergence of divergent, new third parties, through initiatives, including (a) medical content... Sample PDF
Trust in Patient-Centered E-Health
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Chapter 9
John Powell, Natalie Armstrong
This chapter deals with the principles and practice of patient and public involvement in e-health research, and discusses some of the issues raised.... Sample PDF
Involving Patients and the Public in E-Health Research
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Chapter 10
Stefano Forti, Barbara Purin, Claudio Eccher
This chapter presents a case study of using interaction design methods for exploring and testing usability and user experience of a Personal Health... Sample PDF
Using Interaction Design to Improve Usability of a PHR User Interface Based on Visual Elements
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Chapter 11
Jiao Ma
This chapter explores the use of Web sites to provide patients with understandable information about the quality and price of healthcare (healthcare... Sample PDF
Healthcare Quality and Cost Transparency Using Web-Based Tools
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Chapter 12
Ann L. Fruhling
This chapter is drawn from a comprehensive study that examined the effect Human-Computer Interaction usability factors had on rural residents’... Sample PDF
Perceptions of E-Health in Rural Communities
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Chapter 13
Elizabeth Cummings, Stephen Chau, Paul Turner
This chapter explores how in developing patient-centred e-health systems it is possible to accommodate heterogeneous characteristics of end-users... Sample PDF
Assessing a Patient-Centered E-Health Approach to Chronic Disease Self-Management
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Chapter 14
Michel J. Sassene
This chapter investigates asthmatics’ reasons for not adopting an e-health system for asthma selfmanagement. An understanding of these reasons is... Sample PDF
Incompatible Images: Asthmatics' Non-Use of an E-Health System for Asthma Self-Management
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Chapter 15
Linda M. Gallant, Cynthia Irizarry, Gloria M. Boone
An extended version of the technology acceptance model (TAM) is applied to study hospital Web sites, one specific area of e-health. In a review of... Sample PDF
Exploring the Technology Adoption Needs of Patients Using E-Health
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Chapter 16
E. Vance Wilson, Nancy K. Lankton
This chapter presents a new rational-objective (R-O) model of e-health use that accounts for effects of facilitating conditions as well as patients’... Sample PDF
Predicting Patients' Use of Provider-Delivered E-Health: The Role of Facilitating Conditions
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About the Contributors