Patients' perceptions of a health information exchange: a pilot program in South Korea

We examined patients' perceived need for a Health Information Exchange (HIE), their preferences regarding information exchange operations, endorsement of the technology, and expected and perceived benefits and concerns about the technology. Through an HIE pilot program in South Korea, we also explored the influence of demographic characteristics and HIE experience on patients' perceptions.

We collected data from patient surveys administered through a structured questionnaire pre- and post-implementation of an HIE in South Korea. The study database contained 730 records collected by survey before program rollout, 306 records from patients who had experienced the HIE, and 180 records in the comparison group A who experienced an offline-based exchange through procedures such as bringing copies of medical records and imaging results from the clinic to the hospital and 208 records in the comparison group B who brought only a referral letter. We computed descriptive statistics based on survey responses and performed multiple analyses of variance and chi-square tests to examine whether patient characteristics and HIE experience influenced responses.

Despite their concerns about information safety and security, respondents in all 4 (1 pre-implementation and 3 post-implementation) surveyed groups indicated an acceptance of and willingness to endorse HIE technology. Eighty percent of respondents with the HIE experience chose HIE as their preferred operation of information exchange whereas the figure was 55% and 59% in the comparison groups A and B, respectively. The proportion of respondents who indicated improved quality as the reason for their willingness to recommend or to participate was higher than the proportion who cited reduced healthcare bills in all 3 groups - 8% in the HIE group and 13% and 23% in the comparison groups A and B, respectively, cited improved quality as the reason and .4% in the HIE group and 4% and 8% in the comparison groups A and B, respectively, cited reduced healthcare bills as the reason.

The public sentiment is favorable for HIE technology in South Korea, but study findings indicate a gap among perceptions of different patient groups. Education and other efforts to give the public accurate information on benefits and adverse effects of the technology are needed. Also, additional objective studies with empirical data should be conducted to obtain quantitative evidence of benefits and adverse effects of the technology.