No abstract

shown that EMRs do increase the accuracy and accessibility of patients' records, large-scale health information systems have often been fraught with problems [4] [5].The literature on health professionals' attitudes towards computerization suggests that whilst there is an increasing trend towards the computerisation of administrative tasks within both hospital and general practices, many doctors and nurses remain apprehensive about the use of EMRs. They are often unconvinced of the advantages, have severe reservations concerning the privacy, confidentiality and security of data, and believe that the costs (both financial and in terms of the time taken to learn how to use the system) outweigh the benefits [6] [7]. Clearly, a hospital-based EMR linking the primary and secondary health sectors will not be readily embraced by primary healthcare professionals unless these concerns are addressed. It is therefore important to obtain practitioners' views prior to implementation in order to install a system that meets the requirements of all the users.

This project investigates public attitudes towards sharing confidential personal health information held in electronic health records (EHRs). The project uses computer assisted telephone interviewing (CATI) to conduct a quantitative national survey of the attitudes of New Zealanders towards access to their personal health information using vignettes. Respondents are presented with vignettes which describe ways in which their health information might be used, and asked about their attitude to and consent for each type of access. The project outcome will be a specification of requirements for an e-consent model meeting the needs of most New Zealanders, thus enabling the potential benefits of electronically sharing confidential health information from EHRs. This article presents preliminary results from the first 1828 respondents. Respondents were most willing to share their information for the purpose of providing care. However, removing their name and address greatly increased the acceptability of sharing information for other purposes.

This article reports the findings of the first stage of an ongoing, longitudinal study into the implementation of an interorganisational electronic medical records (EMR) system. The study adapted and expanded Davis' (1993) technology acceptance model (TAM) to investigate the attitudes of primary care practitioners towards a proposed system for maternity patients. All doctors and midwives holding maternity care contracts with a large urban hospital in New Zealand were sent a questionnaire soliciting their views on a planned EMR system linking the hospital and the primary care sectors. The results showed that whilst Davis' two key factors of perceived ease of use and perceived usefulness were important to medical professionals, another key factor, perceived system acceptability, which concerns control and management of information is vitally important to the acceptance of the system. The study also showed that the two groups of professionals had differing requirements due to different levels of experience and practice computerisation. Finally, the research highlights a number of wider organisational issues particularly relevant to the use of inter-organisational systems in general and healthcare systems in particular.

New Zealand is moving towards an integrated health-care model with information accessible electronically regardless of location, linking existing health provider systems, regional clinical results repositories and a shared care record. However, such information sharing has been a major concern for patients attending sexual health services. In this study, we investigated patient attitudes towards a change in practice to support an integrated care model. Outcomes showed that confidentiality remains a significant concern, and routine sharing of patient information may create barriers to attendance for some, leading to a potential increase in untreated infections. We conclude that sexual health services may be able to change their information management practices to an opt-out consent system and routinely share health information with other health providers, but further public discussion to ensure informed consent is needed before this can happen. Regardless of national policy, it is still necessary to keep clinic visit details confidential for some patients attending sexual health services.