Background

The lack of interoperability is one of the biggest obstacles to the complete digitalization of patient health information in electronic medical records (EMR). The high volume of data breaches has put pressure on care providers to adopt data protection measures to remain compliant with legal requirements. Extreme data protection measures can impede information flow, but they also instill confidence in secure information sharing. This study investigates how the adoption of security measures, privacy regulations, and communication standards has impacted patient health information interoperability at technical (TI), semantic (SI), and organizational (OI) levels within the hospitals.

Methods

The study utilizes a quasi-experimental research design to probe the relationships of interest. Secondary data from a survey of randomly selected 773 hospitals conducted by the European Commission in over 30 countries in Europe is used to understand the relationships. The study counters selection bias and accounts for systematic differences in adopting treatments of interest in the hospitals using the propensity score-based approaches for the observational data.

Results

The empirical models that account for selection bias explain more observational data variations than those that did not. Access control measures on workstations are linked to 44 % lesser odds of experiencing TI problems. However, hospitals with regional and organizational level privacy regulations have 85 % and 76 % higher odds of experiencing SI and OI problems, respectively. On the other hand, hospitals with a single hospital-wide EMR are 53 % and 43 % less likely to experience TI and SI problems, respectively, in comparison to those with multiple EMR systems.

Conclusion

The study highlights the differential impacts of data protection measures on the hospitals' three key types of interoperability problems (i.e., TI, SI, and OI). Homogenous EMR systems type and substantial investment in technology are critical to supporting health information interoperability within the hospitals. The study findings inform policy considerations for improving specific aspects of health information's interoperability while preserving patient data privacy and security.

中文翻译：

---

数据安全措施，隐私法规和通信标准是否会影响患者健康信息的互操作性？越野调查

背景

缺乏互操作性是电子病历（EMR）中患者健康信息完全数字化的最大障碍之一。大量的数据泄露给医疗服务提供者施加了压力，要求其采取数据保护措施以符合法律要求。极端的数据保护措施可能会阻碍信息流动，但也会灌输对安全信息共享的信心。这项研究调查了安全措施，隐私法规和通信标准的采用如何影响医院内技术（TI），语义（SI）和组织（OI）级别的患者健康信息互操作性。

方法

该研究利用准实验研究设计来探究感兴趣的关系。由欧洲委员会在欧洲30多个国家/地区随机选择的773家医院进行的调查得出的二级数据用于了解这种关系。该研究克服了选择偏见，并使用了基于倾向评分的方法对医院的观察数据进行解释，说明了在医院采用感兴趣的治疗方法时的系统差异。

结果

解释选择偏差的经验模型比未解释的解释更多的观测数据差异。工作站上的访问控制措施可将遇到TI问题的几率降低44％。但是，具有区域和组织级别隐私法规的医院遇到SI和OI问题的几率分别高出85％和76％。另一方面，与拥有多个EMR系统的医院相比，拥有单个医院范围的EMR的医院发生TI和SI问题的可能性分别降低53％和43％。

结论

该研究强调了数据保护措施对医院的三种主要互操作性问题（即TI，SI和OI）的不同影响。均匀的EMR系统类型和对技术的大量投资对于支持医院内的健康信息互操作性至关重要。该研究结果为改善健康信息互操作性的特定方面，同时保留患者数据的隐私和安全性提供了政策考虑。