Abstract
Health care has entered the electronic domain. This domain has improved data collection and storage abilities while allowing almost instantaneous access and results to data queries. Furthermore it allows direct communication between healthcare providers and health consumers. The development of privacy, confidentiality and security principles are necessary to protect consumers' interests against inappropriate access. The electronic health systems vendors have dominated the transition of media, claiming it will improve the quality and coherence of the care process. However, numerous studies show that the health consumer is the important stakeholder in this process, and their views are suggesting that the electronic medium is the way forward, but not just yet. With the international push towards Electronic Health Records (EHRs) by the Health and Human Services (United States of America), National Health Service (United Kingdom), Health Canada (Canada) and more recently the Ministry of Health (New Zealand), this paper presents the role EHRs will play in the health sector.
A comprehensive literature review has revealed that there is a ambiguous use of terminology in the field of electronic records. This ambiguous use of terms is an important factor leading to the lack of clearly understanding what an EHR is. This thesis investigates the benefits that are offered by EHRs as well as investigating the problems and issues that are an integral part of the EHR not being popular. The main problem is found to be consumer's lack of confidence in the security of the EHR system.
This study was conducted to determine the perceptions that the New Zealand health consumer has regarding the security of an EHR. A survey was completed by 300 participants from the four major city centres; Auckland, Wellington, Christchurch and Dunedin. The sample size allowed both descriptive and statistical models to be applied to it, thus producing both valid and meaningful results.
The key finding from this study is that there is a general concern about the security, privacy and confidentiality associated with health consumers medical records. However, there is only a small difference between health consumers who feel paper records are more secure than EHRs and those who feel otherwise. The findings indicate the areas that consumers are most concerned about, as well as the areas that they feel would make their EHR safer.
The survey concludes that for the EHR to be fully integrating in the health sector, there are two main issues that need to be addressed.
1) The security of the EHR system has to be of the highest levels, and needs to be constantly monitored and updated. This can only happen by the development of Standards or regulations that are policed by an accreditation body to ensure total compliance and
2) The involvement of the health consumer in a more proactive role in the ownership and maintenance of their health record. The EHR aims to collect information to allow for "cradle to the grave" treatment, thus the health consumer has to be seen a major player in ensuring that this can happen correctly.
The results from this study indicate the health consumer needs to be assured of the security of an electronic system before they can accept it.