Safeguarding patient privacy in eHealth systems: Bridging theory and practice through a scoping review and healthcare...

The integration of eHealth technologies in hospitals has transformed patient care while raising privacy concerns. To address the latter, this paper combines a scoping review with a survey of healthcare professionals to examine both theoretical and practical aspects of privacy in hospital eHealth systems. Publications from 2021 to June 2024 focusing on privacy in hospital eHealth systems were reviewed. Literature was retrieved from PubMed, IEEE Xplore, ACM Digital Library, and Web of Science, resulting in 1,556 initial records. Additionally, 122 healthcare professionals from Swiss and German hospital networks were surveyed using purposive and convenience sampling regarding their perceptions of privacy measures and implementation challenges. From 434 included studies, 339 focused on technical measures, 40 on organizational processes, 29 on patient perspectives and ethical considerations, and 26 on legal and regulatory aspects. Key technical advancements included blockchain and AI. The survey revealed that participants primarily associated privacy with confidentiality of patient data and protection against unauthorized access. Most identified insufficient training, lack of standardization, and inadequate existing measures as key implementation challenges, thus highlighting gaps between theoretical privacy concepts and practical implementation in healthcare settings. While technical solutions dominate the literature, the survey emphasizes the importance of staff perspectives, particularly regarding confidentiality, access controls, training, and standardization. An integrated framework addressing technical, organizational, and workflow-specific privacy measures is proposed to bridge the theory-practice gap. Future eHealth privacy frameworks should balance technological innovation with practical implementation considerations that incorporate healthcare professionals' insights to effectively safeguard patient data.