Journal of the Korean Society for information Management (정보관리학회지)

Korean Society for Information Management (한국정보관리학회)
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Study on the Factors Affecting the Intention to Share Electronic Medical Records

전자의무기록 공유 의도에 영향을 미치는 요인 연구

  • 김영은 (연세대학교 문헌정보학과) ;
  • 이지연 (연세대학교 문헌정보학과)
  • Received : 2024.02.15
  • Accepted : 2024.03.12
  • Published : 2024.03.30
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Abstract

This study examined the factors affecting the intention of the public to share electronic medical records(EMR) based on the theory of reasoned action and the privacy calculus model. It also investigated whether the purpose of EMR sharing varies depending on personal characteristics, such as the degree of interest in health and personal medical history. According to an online survey of 145 people, altruistic enjoyment, awareness of personal information protection, recognition of legal and institutional roles, and interest in health had a positive impact on the level of EMR sharing, and trust in hospitals positively adjusted the relationship between recognition of legal and institutional roles and sharing intentions. Accordingly, we confirmed that the public recognized the role of the government and hospitals in the sharing process as necessary. The public interest benefits of sharing are critical to activating public participation in the sharing of EMR, and it is also essential to prepare guidelines that legally guarantee the security and proper use of EMR.

전자의무기록 공유를 추진하기 위해서는 사람들의 인식을 이해할 필요가 있다. 이에 본 연구는 합리적 행동 이론과 프라이버시 계산 모형에 기반하여 전자의무기록 공유에 영향을 미치는 요인을 검증하였다. 또한 직업과 개인 병력 등 인구통계학적 특성에 따라 공유 의도가 달라지는지에 대해서 알아보았다. 145명을 대상으로 온라인 설문조사를 실시한 결과, 이타적 즐거움과 개인정보 보호 인식, 법·제도적 역할 인식 및 건강에 관한 관심 정도가 전자의무기록 공유 의도에 긍정적 영향을 미치고 있었으며 의료기관에 대한 신뢰가 법·제도적 역할 인식과 공유 의도 간의 관계를 긍정적으로 조절하였다. 이에 사람들이 공유 과정에 의료기관뿐만 아니라 정부의 역할도 중요하게 인식하고 있음을 확인할 수 있었다. 전자의무기록 공유에 대한 사람들의 참여와 수용을 촉진하기 위해서는 공유로 인한 공익적 혜택을 강조해야 할 것이며 법적으로 개인정보의 보안과 올바른 활용을 보장하는 가이드라인을 마련하는 것이 필요하다는 점을 제시하였다.

Keywords

Acknowledgement

이 논문은 2022년 대한민국 교육부와 한국연구재단의 지원을 받아 수행된 연구임 (NRF-2022S1A5C2A03093597).

References

  1. Ahn, Yoonae & Cho, Hanjin. (2019). A study on clinical decision support system based on common data model. Journal of the Korea Convergence Society, 10(11), 117-124. https://doi.org/10.15207/JKCS.2019.10.11.117
  2. Baek, Juha, Kang, Heechung, Oh, Sujin, & Kang, Sunghong (2022). A Comparative Study of Five Countries on Expanding Electronic Medical Record (EMR) Certification System: Focusing on Supports for Small Hospitals. Korea Institute for Health and Social Affairs.
  3. Choi, Inyoung & Park, Heykyung (2020). A study on cognition and component factors of privacy focusing on inpatients at general hospitals. Journal of Integrated Design Research, 19(3), 63-77. http://dx.doi.org/10.21195/jidr.2020.19.3.004
  4. Choi, Juhee, Chun Kyungju, Lee, Sangok, Kim, Yoori, Pak, Juhyun, Chang, Chulhun, & Kim, Sungsoo (2016). A study of general population's awareness and attitudes toward medical records: Focusing on open notes. The Journal of the Korea Contents Association, 16(9), 213-224. https://doi.org/10.5392/JKCA.2016.16.09.512
  5. Choi, Juhee, Seol, Heeyun, & Kim, Sungsoo (2016) Hospital worker's awareness and attitude towards medical records and open notes. The Journal of the Korea Contents Association, 20(12), 635-645. https://doi.org/10.5392/JKCA.2020.20.12.635
  6. Choi, Miyoung (2008). An Empirical Analysis about Privacy Concerns and Overcome on the Online. Master's thesis, Hanyang University.
  7. Go, Youngjin (2016). Job Stress, Work Pressure, Job Burnout and Satisfaction by the use of Electronic Medical Records of Nurses in University Hospital. Master's thesis, Konyang University.
  8. Hwang, Kyoungil, Shim, Hyunjin, & Rhee, Hyunsil (2017). Influence of emotional labor on the job stress of the contact department in a general hospital moderation analysis of foundation and occupation. The Korean Journal of Health Service Management, 11(2), 17-27. https://doi.org/10.12811/kshsm.2017.11.2.01
  9. Kim, Byoungsoo (2014). Analyzing SNS users' knowledge sharing behaviors in a big data era: A privacy calculus model perspective. The e-Business Studies, 15(1), 297-315. http://doi.org/10.15719/geba.15.1.201402.291
  10. Kim, Hyojung (2021). Intention of information sharing: Fitness applications with smart watch. Journal of Consumer Studies, 32(6), 101-120, http://doi.org/10.35736/JCS.32.6.5
  11. Kim, Kihyun (2022). High School Students' Perceptions of the Introduction of Artificial Intelligence to Science Classes. Master's thesis, Korea National University of Education.
  12. Kim, Kyehyun (2015). Trends in electronic health records incentives in the U.S. Journal of the Korean Medical Association, 13(1), 124-128.
  13. Kim, Kyungmin, Nam, Jiae, & Kim, Hyejin (2021). Relationship between medical engineers' emotional labor and job stress. Journal of Next-generation Convergence Technology Association, 5(4), 564-572. https://doi.org/10.33097/JNCTA.2021.05.04.564
  14. Kim, Sanghyun & Song, Youngmi (2010). A study on the motivating factors influencing intention to share individual users' knowledge in social networking service. The e-Business Studies, 11(3), 327-346. http://doi.org/10.15719/geba.11.3.201009.327
  15. Kim, Youngsin (2023. May 09). Boramae Medical Center, Development of CDM. Medical World News. Available: https://medicalworldnews.co.kr/news/view.php?idx=1510955425.
  16. Lee, Daeun & Kim, Seokkwan (2018). Digital Healthcare Innovation Trends and Policy Implications. Science and Technology Policy Institute.
  17. Lee, Dongman & Park, Hyunsun (2011). The effects of individual psychological and social motivation factors on information sharing intention through social media. The Journal of Internet Electronic Commerce Research, 11(2), 1-21.
  18. Lee, Hansuk (2016). Effect of perceived risk, perceived benefit, and Korea wave to crowdfunding participation in China. The Journal of the Korea Contents Association, 16(1), 204-213. http://dx.doi.org/10.5392/JKCA.2016.16.01.204
  19. Lee, Inhye & Jin, Jungha (2022). Proposal of law amendment for secure management and preservation of EMR. The Journal of Korean Institute of Communications and Information Sciences, 47(11), 1908-1917. http://doi/10.7840/kics.2022.47.11.1908
  20. Lee, Jungmin & Jang, Kiwon (2020). The influence of medical workers' emotional labor on somatic symptoms-focusing on mediating effects of depression and anxiety. Journal of Korea Academia-Industrial Cooperation Society, 21(11), 586-594. https://doi.org/10.5762/KAIS.2020.21.11.586
  21. Lee, Juyeon, Kim, Yong, & Kim, Geon (2013). A study on the analysis and methods to improve the medical records management in a large university hospital. Journal of Korean Society of Archives and Records Management, 13(1), 107-134.
  22. Moon, Yong (2020). A study on the development issues of digital health care medical information. Industry Promotion Research, 7(3), 17-26. https://doi.org/10.21186/IPR.2022.7.3.017
  23. Park, Gilha (2017). A trends of big data processing for digital healthcare. The Korea Contents Association, 15(1), 35-37.
  24. Park, Hyunsun & Lee, Dongman (2011). A study on the effect of information sharing motivation factors on information sharing intention in social media. Paper Presented at the Conference of the Korean Association Of Industrial Business Administrarion, 160-470.
  25. Ryu, Wooseok (2014). Requirement analysis of search browser for efficient searching of clinical terminology. Journal of the Korea Institute Of Information and Communication Engineering, 14(11), 2691-2696. http://doi/10.6109/jkiice.2014.18.11.2691
  26. Shin, Suyong (2018). Standardize unstructured healthcare data. Information and Communications Magazine, 35(2), 58-64.
  27. Wang, Jaesun & Moon, Junguk (2017). A study of information sharing barriers: Focusing on the type and degree of information sharing. Journal of Korean Association for Regional Information Society, 20(1), 57-85. http://doi.org/10.22896/karis.2017.20.1.003
  28. Yook, Soyoung & Yang, Daeseung (2022). The legal analysis of sharing health information. IT&LAW Review, (25), 145-178.
  29. Ajzen, I. & Fishbein, M. (1980). Understanding Attitudes and Predicting Social Behavior. New Jersey: Prentice Hall.
  30. Al-Husseini, S. J. (2021). Social capital and individual motivations for information sharing: A theory of reasoned action perspective. Journal of Information Science, 49(6), 1493-1505. https://doi.org/10.1177/01655515211060532
  31. Ashley, E. A., Butte, A. J., Wheeler, M. T., Chen, R., Klein, T. E., Dewey, F. E., Dudley, J. T., Ormond, K. E., Pavlovic, A., Morgan, A. A., Pushkarev, D., Neff, N. F., Hudgins, L., Gong, L., Hodges, L. M., Berlin, D. S., Thorn, C. F., Sangkuhl, K., Hebert, J. M., Woon, M., Sagreiya, H., Whaley, R., Knowles, J. W., Chou, M. F., Thakuria, J. V., Rosenbaum, A. M., Zaranek, A. W., Church, G. M., Greely, H. T., Quake, S. R., & Altman, R. B. (2010). Clinical assessment incorporating a personal genome. The Lancet, 375(9725), 1525-1535. https://doi.org/10.1016/S0140-6736(10)60452-7
  32. Baier, A. W., Snyder, D. J., Leahy, I. C., Patak, L. S., & Brustowicz, R. M. (2017). A shared opportunity for improving electronic medical record data. Anesthesia & Analgesia, 125(3), 952-957. https://doi.org/10.1213/ANE.0000000000002134
  33. Bock, G. W. & Kim, Y. G. (2002). Breaking the myths of rewards: An exploratory study of attitudes about knowledge sharing. Information Resources Management Journal, 15(2), 14-21. http://doi.org/10.4018/irmj.2002040102
  34. Bock, G. W., Zmud, R. W., Kim, Y. G., & Lee, J. N. (2005). Behavioral intention formation in knowledge sharing: Examining the roles of extrinsic motivators, social-psychological forces, and organizational climate. Management Information Systems Quarterly, 87-111. https://doi.org/10.2307/25148669
  35. Brown, S. M., Bell, S. K., Roche, S. D., Dente, E., Mueller, A., Kim, T. E., O'Reilly, K., Lee, B. S., Sands, K., & Talmor, D. (2016). Preferences of current and potential patients and family members regarding implementation of electronic communication portals in intensive care units. Annals of the American Thoracic Society, 13(3), 391-400. https://doi.org/10.1513/AnnalsATS.201509-638OC
  36. Cabrera, A. & Cabrera, E. F. (2005). Fostering knowledge sharing through people management practices. The International Journal of Human Resource Management, 16(5), 720-735. https://doi.org/10.1080/09585190500083020
  37. Clay, R. A. (2012). The advantages of electronic health records. Paper presented at the State Leadership Conference, 43(5), 72. Available: https://www.apa.org/monitor/2012/05/electronic-records
  38. Cocosila, M. & Archer, N. (2014). Perceptions of chronically ill and healthy consumers about electronic personal health records: a comparative empirical investigation. British Medical Journal Open, 4(7), e005304. https://doi.org/10.1136/bmjopen-2014-005304
  39. Culnan, M. J. & R, J. Bies. (2003). Consumer privacy: Balancing economic and justice considerations. Journal of Social Issues, 59(2), 323-342. https://doi.org/10.1111/1540-4560.00067
  40. Cummings, N. (2004). Work groups, structural diversity, and knowledge sharing in a global organization. Management Science, 50(3), 352-364. https://doi.org/10.1287/mnsc.1030.0134
  41. Daniel, A. M., Mouter, N., & Chorus, C. G. (2023). For me or for my relatives? Approximating self-Protection and local altruistic motivations underlying preferences for public health policies using risk perception metrics. Value in Health, 26(1), 99-103. https://doi.org/10.1016/j.jval.2022.05.017
  42. De Waal, F. B. & Preston, S. D. J. (2017). Mammalian empathy: behavioural manifestations and neural basis. Nature Reviews Neuroscience, 18(8), 498-509. https://doi.org/10.1038/nrn.2017.72
  43. Devellis, R. F. (2012). Scale Development: Theory and Applications. Los Angeles: Sage. 
  44. Dinev, T. & Hart, P. (2006). An extended privacy calculus model for e-commerce transactions. Information Systems Research, 17(1), 61-80. https://doi.org/10.1287/isre.1060.0080
  45. Edwards, A., Hollin, I., Barry, J., & Kachnowski, S. (2010). Barriers to cross--institutional health information exchange: a literature review. Journal of Healthcare Information Management, 24(3), 22-34.
  46. Entzeridou, E., Markopoulou, E., & Mollaki, V. (2018). Public and physician's expectations and ethical concerns about electronic health record: Benefits outweigh risks except for information security. International Journal of Medical Informatics, 110, 98-107. http://doi.org/10.1016/j.ijmedinf.2017.12.004
  47. Fishbein, M. & Ajzen, I. (1977). Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Massachusetts: Addison-Wesley.
  48. Fitzpatrick, G. (2000). Understanding the paper health record in practice: implications for EHRs. CD-ROM Proceedings of the Health Informatics Conference.
  49. Fontaine, P., Zink, T., Boyle, R. G., & Kralewski, J. (2010). Health information exchange: participation by Minnesota primary care practices. Archives of Internal Medicine, 170(7), 622-629. https://doi.org/10.1001/archinternmed.2010.54
  50. Hansen, M. (1999). The search-transfer problem: The role of weak ties in sharing knowledge across organization subunits. Administrative Science Quaterly, 44(1), 82-111. https://doi.org/10.2307/2667032
  51. Harris, T., Cook, D. G., Victor, C., Beighton, C., DeWilde, S., & Carey, I. (2005). Linking questionnaires to primary care records: factors affecting consent in older people. Journal of Epidemiology & Community Health, 59(4), 336-338. https://doi.org/10.1136/jech.2004.025296
  52. He, Y., He, Q., Li, L., Wang, W., Zha, W., & Liu, Q. (2022). Factors affecting willingness on sharing of electronic health records data: A survey on chinese residents. Journal of Oncology, 1-8. https://doi.org/10.1155/2022/5280792
  53. Isah, E. E. & Bystrom, K. (2020). The mediating role of documents: information sharing through medical records in healthcare. Journal of Documentation, 76(6), 1171-1191. https://doi.org/10.1108/JD-11-2019-0227
  54. Jayanti, R. K. & Burns, A. C. (1998). The antecedents of preventive health care behavior: An empirical study. Journal of the Academy of Marketing Science, 26(1), 6-15. https://doi.org/10.1177/0092070398261002
  55. Jiang, R., Liu, R., Zhang, T., Ding, W., & Tian, S. (2024). An electronic medical record access control model based on intuitionistic fuzzy trust. Information Sciences, 658, 120054. https://doi.org/10.1016/j.ins.2023.120054
  56. Kim K. K., Sankar P., Wilson M. D., & Haynes S. C. (2017). Factors affecting willingness to share electronic health data among California consumers. BioMed Central Medical Ethics. 18. https://doi.org/10.1186/s12910-017-0185-x
  57. Korea Health Information Service (2023). EMR Certification. Available: https://www.k-his.or.kr/menu.es?mid=a10201010100
  58. Krasnova, H., Veltri, N. F., & Gunther, O. (2012). Self-disclosure and privacy calculus on social networking sites: The role of culture. Business & Information Systems Engineering, 4(3), 127-135. https://doi.org/10.1007/s11576-012-0323-5
  59. Krousel-Wood, M., McCoy, A. B., Ahia, C., Holt, E. W., Trapani, D. N., Luo, Q., Price-Haywood, E. G., Thomas, E. J., Sittig, D. F., & Milani, R. (2018). Implementing electronic health records (EHRs): health care provider perceptions before and after transition from a local basic EHR to a commercial comprehensive EHR. Journal of the American Medical Informatics Association, 25(6), 618-626. http://doi.org/10.1093/jamia/ocx094
  60. Kruse, C. S., Kothman, K., Anerobi, K., & Abanaka, L. (2016). Adoption Factors of the Electronic Health Record: A Systematic Review. Journal of Medical Internet Research. Med Inform, 4(2), e19. https://doi.org/10.2196/medinform.5525
  61. Laufer, R. S. & Wolfe, M. (1977). Privacy as a concept and a social issue: A multidimensional developmental theory. Journal of social Issues, 33(3), 22-42. https://doi.org/10.1111/j.1540-4560.1977.tb01880.x
  62. Lee, M. K., Cheung, C. M., Lim, K. H., & Ling Sia, C. (2006). Understanding customer knowledge sharing in web based discussion boards: An exploratory study. Internet Research, 16(3), 289-303. https://doi.org/10.1108/10662240610673709
  63. Lin, H. F. (2007). Effects of extrinsic and intrinsic motivation on employee knowledge sharing intentions. Journal of Information Science, 33(2), 135-149. https://doi.org/10.1177/0165551506068174
  64. Malhotra, N. K., Kim, S. S. & Agarwal, J. (2004). Internet users' information privacy concerns (IUIPC): The construct, the scale, and a causal model. Information Systems Research, 15(4), 336-355. https://doi.org/10.1287/isre.1040.0032
  65. Menachemi, N. & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 4, 47-55. http://dx.doi/10.2147/RMHP.S12985
  66. Niu, S., Liu, W., Han, S., & Fang, L. (2021). A data-sharing scheme that supports multi-keyword search for electronic medical records. Plos One, 16(1), e0244979. https://doi.org/10.1371/journal.pone.0244979
  67. Nonaka, I. (1994). A dynamic theory of organizational knowledge creation. Organization Science, 5(1), 14-37. https://doi.org/10.1287/orsc.5.1.14
  68. Park, H., Lee, S. I., Hwang, H., Kim, Y., Heo, E. Y., Kim, J. W., & Ha, K. (2015). Can a health information exchange save healthcare costs? Evidence from a pilot program in South Korea. International Journal of Medical Informatics, 84(9), 658-666. https://doi.org/10.1016/j.ijmedinf.2015.05.008
  69. Park, R. W. (2017). Sharing clinical big data while protecting confidentiality and security: observational health data sciences and informatics. Healthcare Informatics Research, 23(1), 1-3. https://doi.org/10.4258/hir.2017.23.1.1
  70. Pearson K. B. & Coburn A. F. (2013). Emergency transfers of the elderly 54 from nursing facilities to critical access hospitals: Opportunities for improving patient safety and quallity. Policy Brief Review, 32.
  71. Saito, K. (2013). Social preferencess under risk: equality of opportunity versus equality of outcome. American Economic Review, 103(8), 3084-3101. https://doi.org/10.1257/aer.103.7.3084
  72. Shin, D. H. (2010). The effects of trust, security and privacy in social networking: A security-based approach to understand the pattern of adoption. Interacting with Computers, 22(5), 428-438. https://doi.org/10.1016/j.intcom.2010.05.001
  73. Vallerand, R. J., Deshaies, P., Cuerrier, J. P., Pelletier, L. G., & Mongeau, C. (1992). Ajzen and Fishbein's theory of reasoned action as applied to moral behavior: A confirmatory analysis. Journal of Personality and Social Psychology, 62(1), 98-109. https://doi.org/10.1037/0022-3514.62.1.98
  74. van Swol, L. M., Kolb, M., & Asan, O. (2020). 'We are on the same page': the importance of doctors EHR screen sharing for promoting shared information and collaborative decision-making. Journal of Communication in Healthcare, 13(2), 129-137. https://doi.org/10.1080/17538068.2020.1777512
  75. van Trotsenburg, P., Stoupa, A., Leger, J., Rohrer, T., Peters, C., Fugazzola, L., Cassio, A., Heinrichs, C., Beauloye, V., Pohlenz, J., Rodien, p., Coutant, R., Szinnai, G., Murray, P., Bartes, B., Luton, D., Salerno, M., de Sanctis, L., Vigone, M., Krude, H., Persani, L., & Polak, M. (2021). Congenital hypothyroidism: A 2020-2021 consensus guidelines update-An ENDO-European reference network initiative endorsed by the European society for pediatric endocrinology and the European Society for Endocrinology. Thyroid, 31(3), 387-419. https://doi.org/10.1089/thy.2020.0333