Perceptions of a Secure Cloud-Based Solution for Data Sharing During Acute Stroke Care: Qualitative Interview Study

Abstract

Background Acute stroke care demands fast procedures performed through the collaboration of multiple professionals across multiple organizations. Cloud computing and the wide adoption of electronic medical records (EMRs) enable health care systems to improve data availability and facilitate sharing among professionals. However, designing a secure and privacy-preserving EMR cloud-based application is challenging because it must dynamically control the access to the patient’s EMR according to the needs for data during treatment. Objective We developed a prototype of a secure EMR cloud-based application. The application explores the security features offered by the eHealth cloud-based framework created by the Advanced Secure Cloud Encrypted Platform for Internationally Orchestrated Solutions in Health Care Horizon 2020 project. This study aimed to collect impressions, challenges, and improvements for the prototype when applied to the use case of secure data sharing among acute care teams during emergency treatment in the Netherlands. Methods We conducted 14 semistructured interviews with medical professionals with 4 prominent roles in acute care: emergency call centers, ambulance services, emergency hospitals, and general practitioner clinics. We used in-depth interviews to capture their perspectives about the application’s design and functions and its use in a simulated acute care event. We used thematic analysis of interview transcripts. Participants were recruited until the collected data reached thematic saturation. Results The participants’ perceptions and feedback are presented as 5 themes identified from the interviews: current challenges (theme 1), quality of the shared EMR data (theme 2), integrity and auditability of the EMR data (theme 3), usefulness and functionality of the application (theme 4), and trust and acceptance of the technology (theme 5). The results reinforced the current challenges in patient data sharing during acute stroke care. Moreover, from the user point of view, we expressed the challenges of adopting the Advanced Secure Cloud Encrypted Platform for Internationally Orchestrated Solutions in Health Care Acute Stroke Care application in a real scenario and provided suggestions for improving the proposed technology’s acceptability. Conclusions This study has endorsed a system that supports data sharing among acute care professionals with efficiency, but without compromising the security and privacy of the patient. This explorative study identified several significant barriers to and improvement opportunities for the future acceptance and adoption of the proposed system. Moreover, the study results highlight that the desired digital transformation should consider integrating the already existing systems instead of requesting migration to a new centralized system.

A Scoping Review on Analysis of the Barriers and Support Factors of Open Data

“…Not all data are suitable for Open Data [10]. However, ensuring data interoperability for analysis and storage is deemed essential [2,13,18,27,31,56]. Various system architectures and data infrastructures are described as a root cause for the lack of interoperability [15,27,31].…”

“…Many datasets are fragmented and stored in various data silos, further limiting their subsequent processing and exchange [6,10,11,15,19,25,27,56]. The fragmentation is, in turn, attributed to differing semantics and data formats [6].…”

“…It is helpful to gain insight into existing technical systems when introducing new systems [6]. Tuler de Oliveira et al point out that merging existing systems is preferable to entirely new systems [56].…”

“…In data use, the highest level of transparency should always be ensured with clarity on the purpose and goal of data sharing [1,25]. The goal should be useful and functional data sharing [56]. Contracts can support a trusting data-sharing relationship in this regard [57].…”

“…Access controls to data are described as a significant and beneficial aspect [19,25,29,34,56]. Developing an access model/access procedure for the data is considered necessary [18,24,53].…”