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首页> 外文期刊>BMC Medical Informatics and Decision Making >Patient and public views about the security and privacy of Electronic Health Records (EHRs) in the UK: results from a mixed methods study
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Patient and public views about the security and privacy of Electronic Health Records (EHRs) in the UK: results from a mixed methods study

机译：病人和公众对英国电子健康记录（EHR）的安全性和隐私的看法：混合方法研究的结果

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Background Although policy discourses frame integrated Electronic Health Records (EHRs) as essential for contemporary healthcare systems, increased information sharing often raises concerns among patients and the public. This paper examines patient and public views about the security and privacy of EHRs used for health provision, research and policy in the UK. Methods Sequential mixed methods study with a cross-sectional survey (in 2011) followed by focus group discussions (in 2012-2013). Survey participants (N?=?5331) were recruited from primary and secondary care settings in West London (UK). Complete data for 2761 (51.8 %) participants were included in the final analysis for this paper. The survey results were discussed in 13 focus groups with people living with a range of different health conditions, and in 4 mixed focus groups with patients, health professionals and researchers (total N?=?120). Qualitative data were analysed thematically. Results In the survey, 79 % of participants reported that they would worry about the security of their record if this was part of a national EHR system and 71 % thought the National Health Service (NHS) was unable to guarantee EHR safety at the time this work was carried out. Almost half (47 %) responded that EHRs would be less secure compared with the way their health record was held at the time of the survey. Of those who reported being worried about EHR security, many would nevertheless support their development (55 %), while 12 % would not support national EHRs and a sizeable proportion (33 %) were undecided. There were also variations by age, ethnicity and education. In focus group discussions participants weighed up perceived benefits against potential security and privacy threats from wider sharing of information, as well as discussing other perceived risks: commercial exploitation, lack of accountability, data inaccuracies, prejudice and inequalities in health provision. Conclusions Patient and public worries about the security risks associated with integrated EHRs highlight the need for intensive public awareness and engagement initiatives, together with the establishment of trustworthy security and privacy mechanisms for health information sharing.
机译：背景技术尽管政策论述将集成的电子病历（EHR）视为现代医疗保健系统必不可少的内容，但增加的信息共享常常引起患者和公众的关注。本文研究了患者和公众对英国用于健康提供，研究和政策的EHR的安全性和隐私性的看法。方法采用先后进行横断面调查的顺序混合方法研究（2011年），然后进行焦点小组讨论（2012-2013年）。调查参与者（N = 5333）是从西伦敦（英国）的初级和二级医疗机构中招募的。本文的最终分析包括了2761位参与者（51.8％）的完整数据。在13个与不同健康状况人群在一起的焦点小组中讨论了调查结果，在4个与患者，卫生专业人员和研究人员混合的焦点小组中对调查结果进行了讨论（总N？= 120）。定性数据进行了专题分析。结果在调查中，有79％的参与者报告说，如果这是国家EHR系统的一部分，他们将担心其记录的安全性;而71％的参与者则认为，在此期间，美国国家卫生服务（NHS）无法保证EHR安全。工作进行了。几乎一半（47％）的回答是，与进行调查时保存电子病历的方式相比，电子病历的安全性较低。在那些报告称担心电子病历安全的人中，许多人仍然支持其发展（55％），而12％的人不支持国家电子病历，并且有很大比例（33％）尚未决定。年龄，种族和教育程度也有所不同。在焦点小组讨论中，参与者权衡了广泛共享信息所带来的潜在利益和潜在的安全与隐私威胁，并讨论了其他感知风险：商业利用，缺乏问责制，数据不准确，偏见和医疗服务不平等。结论结论患者和公众对与集成电子病历相关的安全风险的担忧突出表明，需要加强公众意识和参与计划，并建立可信赖的安全和隐私机制以共享健康信息。

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