Perceptions of a secure cloud-based solution for data sharing during acute stroke care: qualitative interview study (Preprint)

Abstract

BACKGROUND Acute stroke care demands fast procedures carried out through the collaboration of multiple professionals across multiple organisations. Cloud computing and the wide adoption of electronic medical records (EMR) enable healthcare 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 patients' EMR according to the needs for data during treatment. OBJECTIVE We developed a prototype of a secure EMR cloud-based application. The application explores security features offered by the eHealth Cloud-based framework created by the ASCLEPIOS Horizon2020 project. This research 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 performed eleven semi-structured interviews with medical professionals with four prominent roles in acute care. We used in-depth interviews to capture their perspectives on the application's design and functions, the implemented design, and its use in a simulated acute care event. We employed thematic analysis of interview transcripts. The recruitment of participants ended when the collected data reached thematic saturation. RESULTS The participants' perceptions and feedback are presented as five themes identified from the interviews: (T1) current challenges, (T2) quality of the shared EMR data, (T3) EMR data integrity and auditability, (T4) application usefulness and functionality, and (T5) trust and acceptance of the technology. The results reinforced the current challenges for patient data sharing during acute stroke care. Moreover, we expressed the challenges of adopting the ASCLEPIOS acute stroke care application in a real scenario, from the user point of view, and 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.