Trust and Privacy in Healthcare

Abstract

This paper considers issues of trust and privacy in healthcare around increased data-sharing through Electronic Health Records (EHRs). It uses a model structured around different aspects of trust in the healthcare organisation’s reasons for greater data-sharing and their ability to execute EHR projects, particularly any associated confidentiality controls. It reflects the individual’s personal circumstances and attitude to use of health records.

This model is extended by considering the relative gains and risks from greater data-sharing as viewed by population segments to give a range of ‘attitudes’: positive, negative, ambivalent/marginal, or contingent.

The model is compared with results from a recent literature survey by the authors published by the UK General Medical Council (GMC) on Public and Professional Attitudes to Privacy.

Various policy options are considered which may modify attitudes to make the proposal more or less attractive to patients, recognising that there are those that have little to gain or will always view the proposition of EHRs negatively, and that time and experience may be needed to resolve doubts.

The paper does not consider legal questions of privacy and medical confidentiality, although the authors are very familiar with these, preferring to focus on how to meet public expectations and concerns.