The Process of Building Patient Trust in Health Information Exchange (HIE): The Impacts of Perceived Benefits, Perceived Transparency of Privacy Policy, and Familiarity

Exchange technologies such as health information exchanges (HIE) currently lack acceptance theories that consider not only cognitive beliefs that result in adoption behavior but also emotional factors that may influence adoption intention. Based on the theory of reasoned action (TRA), the technology-adoption literature, and the trust literature, I theoretically explain and empirically test the impact that perceived benefits, perceived transparency of privacy policy, and familiarity have on cognitive trust and emotional trust in HIE. Moreover, I analyze the effect that cognitive trust and emotional trust have on individuals’ intention to opt into HIE and their willingness to disclose health information. I conducted an online survey using data from individuals who knew about HIE through experiences with providers that participated in a regional consumer-mediated HIE network. In my SEM analysis, I found empirical support for the proposed model. My findings indicate that, when patients know more about HIE benefits, HIE sharing procedures, and privacy guidelines, they feel more in control, more assured, and less at risk. The results also show that patient trust in HIE may take the forms of intentions to opt in to HIE and patients’ willingness to disclose personal health information that providers exchange through the HIE. I discuss the implications my results have for both academics and practitioners.