Background Patients may seek health care services from various providers during treatment. These providers could serve in a network (affiliated) or practice separately (unaffiliated). Thus, using secure and reliable health information exchange (HIE) mechanisms would be critical to transfer sensitive personal health information (PHI) across distances. Studying patients' perceptions and opinions about exchange mechanisms could help health care providers build more complete HIEs' databases and develop robust privacy policies, consent processes, and patient education programs.

Objectives Due to the exploratory nature of this study, we aim to shed more light on public perspectives (benefits, concerns, and risks) associated with the four data exchange practices in the health care sector.

Methods In this study, we compared public perceptions and expectations regarding four common types of exchange mechanisms used in the United States (i.e., traditional, direct, query-based, patient-mediated exchange mechanisms). Traditional is an exchange through fax, paper mailing, or phone calls, direct is a provider-to-provider exchange, query-based is sharing patient data with a central repository, and patient-mediated is an exchange mechanism in which patients can access data and monitor sharing. Data were collected from 1,624 subjects using an online survey to examine the benefits, risks, and concerns associated with the four exchange mechanisms from patients' perspectives.

Results Findings indicate that several concerns and risks such as privacy concerns, security risks, trust issues, and psychological risks are raised. Besides, multiple benefits such as access to complete information, communication improvement, timely and convenient information sharing, cost-saving, and medical error reduction are highlighted by respondents. Through consideration of all risks and benefits associated with the four exchange mechanisms, the direct HIE mechanism was selected by respondents as the most preferred mechanism of information exchange among providers. More than half of the respondents (56.18%) stated that overall they favored direct exchange over the other mechanisms. 42.70% of respondents expected to be more likely to share their PHI with health care providers who implemented and utilized a direct exchange mechanism. 43.26% of respondents believed that they would support health care providers to leverage a direct HIE mechanism for sharing their PHI with other providers. The results exhibit that individuals expect greater benefits and fewer adverse effects from direct HIE among health care providers. Overall, the general public sentiment is more in favor of direct data transfer. Our results highlight that greater public trust in exchange mechanisms is required, and information privacy and security risks must be addressed before the widespread implementation of such mechanisms.

Conclusion This exploratory study's findings could be interesting for health care providers and HIE policymakers to analyze how consumers perceive the current exchange mechanisms, what concerns should be addressed, and how the exchange mechanisms could be modified to meet consumers' needs.

背景 患者在治疗期间可能会从不同的提供者那里寻求医疗保健服务。这些提供者可以在一个网络中服务（附属）或单独执业（非附属）。因此，使用安全可靠的健康信息交换 (HIE) 机制对于跨距离传输敏感的个人健康信息 (PHI) 至关重要。研究患者对交流机制的看法和意见可以帮助医疗保健提供者建立更完整的 HIE 数据库，并制定健全的隐私政策、同意程序和患者教育计划。

目标 由于本研究的探索性，我们旨在更多地阐明与医疗保健部门四种数据交换实践相关的公众观点（收益、关注点和风险）。

方法 在这项研究中，我们比较了公众对美国使用的四种常见类型的交换机制（即传统的、直接的、基于查询的、以患者为中介的交换机制）的看法和期望。传统是通过传真、纸质邮件或电话进行交换，直接是提供者到提供者的交换，基于查询是与中央存储库共享患者数据，而患者中介是患者可以访问数据的交换机制和监控共享。使用在线调查从 1,624 名受试者中收集数据，以从患者的角度检查与四种交换机制相关的益处、风险和担忧。

结果 调查结果表明，提出了一些担忧和风险，例如隐私问题、安全风险、信任问题和心理风险。此外，受访者还强调了获得完整信息、改善沟通、及时便捷的信息共享、节省成本和减少医疗差错等多重好处。通过考虑与四种交换机制相关的所有风险和收益，受访者选择直接 HIE 机制作为供应商之间最喜欢的信息交换机制。超过一半的受访者 (56.18%) 表示总体上他们更喜欢直接交换而不是其他机制。42.70% 的受访者预计更有可能与实施和利用直接交换机制的医疗保健提供者分享他们的 PHI。43. 26% 的受访者认为他们将支持医疗保健提供者利用直接 HIE 机制与其他提供者共享他们的 PHI。结果表明，个人期望从医疗保健提供者中直接 HIE 获得更大的好处和更少的不利影响。总体而言，公众情绪更倾向于直接数据传输。我们的结果强调需要公众对交换机制有更大的信任，并且必须在广泛实施此类机制之前解决信息隐私和安全风险。公众的情绪更倾向于直接数据传输。我们的结果强调需要公众对交换机制有更大的信任，并且必须在广泛实施此类机制之前解决信息隐私和安全风险。公众的情绪更倾向于直接数据传输。我们的结果强调需要公众对交换机制有更大的信任，并且必须在广泛实施此类机制之前解决信息隐私和安全风险。

结论 这项探索性研究的发现可能对医疗保健提供者和 HIE 政策制定者分析消费者如何看待当前的交换机制、应解决哪些问题以及如何修改交换机制以满足消费者的需求感兴趣。