Chapter 5: Method and Results
5.2 Results
43 indicators. Another limitation is that the responses to the survey may not be
entirely truthful, which means that the indicator measurement may not be valid.
Getting healthcare professionals and healthcare management people to do the survey was a hard task because it is highly likely that they were afraid to give their answers openly and because it was related to a sensitive part of their jobs.
B. Reliability: This study is considered reliable because it could be repeated. The respondents are representatives of the total population since the attempts to reach out to people from every emirate was successful insofar as it was possible.
However, getting a larger number will yield in more great findings.
C. Generalizability: It is a factor concerning the possibility of the information being applied in another country. The study results would differ if the study were conducted in any other country where people's perceptions of new technologies would undoubtedly change depending on how the government acts, as the results here reflect the UAE people's perceptions.
All ethics rules and regulations imposed by the Research Ethics Committee of the United Arab Emirates University were followed, and on the 24th of May 2022, ethics approval was obtained from the committee. All respondents were informed of their rights, and all academic morals and ethics were followed, so personal data was not obtained or released. Moreover, all the respondents were given a brief
introduction to Blockchain before starting to answer the survey.
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The responses received can be divided into three groups: the general public, healthcare professionals, and employees in health management as stated earlier. Out of the 105 participants, 65 are employed; 16 respondents are healthcare professionals, in addition to 3 employees in a related job for the management of healthcare entities (a receptionist in a healthcare entity deals with EHRs daily, an employee of Daman health insurance, and an employee works in the administration of a healthcare entity).
A. Health/Medical Data section:
1. The question “Do you want to be able to control who can have access to your EHR, such as who can view, update, or use it for research or treatments?”
Figure 4: Control Access to EHRs
As it is shown in Figure 4, 74.3% responded that they wished to have such control. 15.2% were unsure about who could have access to their EHR. While 10.5%
of them didn’t want to be able to control EHR access.
2. The question “How comfortable are you with the idea of other organizations (hospitals, research centers …) viewing your EHR?”
45 Figure 5: Comfortable Viewing the EHR
Figure 5 shows that 34.3% of respondents are uncomfortable with other entities viewing their EHR. While, 32.4% were neutral about it. Whereas 29.5% said they are comfortable, 3.8% said they don't care.
3. The question “Are you worried about data leakage and other users having unauthorized access to stored EHRs?”
Figure 6: Unauthorized Access to the EHRs
Clearly shown in Figure 6, 45.7% were worried about data leakage and other users having unauthorized access to stored EHRs. On the other hand, 39% express their worries as partially worrying, which leaves us with 15.2% who did not worry.
4. The question “How safe and private do you believe EHRs are?”
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Figure 7: EHRs Safety and Privacy
As shown in Figure 7, 34.3% of the responses were "Safe, but needs improvement," whereas 31.4% said "Somewhat safe." 23.8% answered
"Questionable" and 8.6% answered "Completely safe." Lastly, "Unsafe" is for 1.9%.
5. The question “Do you think that sharing an EHR internationally should affect the kind of information being shared?”
Figure 8: Type of Information Shared
In Figure 8, "Yes, some data should be redacted" was checked by 54.3% of responders. Moreover, 21.9% answered "Don’t know" whereas 16.2% answered
"Yes, additional data should be added." That leaves 7.6% for the answer "No."
6. The question “Are there measures in place, that you are aware of, to prevent unauthorized parties from accessing EHRs as they are being shared with another organization?”
47 Figure 9: People's Awareness of Preventive Measures for EHRs
As it is shown in Figure 9, three answers were provided for the respondents.
57.1% didn’t know about the measures taken for the prevention of unauthorized access while the EHRs are shared, and 23.8% were aware of such preventive approaches. On the other hand, 19% have no clue about such measures.
B. Blockchain Technology:
1. The question “If the use of Blockchains for EHRs sharing will ensure security and privacy of EHRs sharing, will you encourage organization to use such a
technology?”
Figure 10: Encourage The use of Blockchain
88.6% encourage the use of Blockchain for EHR sharing while 11.4% don’t, as is clearly shown in Figure 10.
2. The question “What benefits do you hope for from using Blockchains for EHRs sharing? (Please select all that apply.)”
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Figure 11: Benefits Gained Using Blockchain for EHRs Sharing
Out of the nine possible answers shown in Figure 11, in first place, the option
"Better data protection provided by Blockchain's ability to eliminate points of failure in business networks" and the option "Reduction of risks" got chosen approximately at the same number. In the second place are the options "Better transaction integrity and visibility," "Time savings," and "Improved business efficiency." In the third place are the options "Increased transaction speed," "Stronger working relationships with partners," and "Lower transaction cost." Only 15 respondents answered "Don’t know," which is the least number. Two responses were received from the (general public) respondents about any other benefits they could add. The first response was that data security, transparency, privacy, accountability, anonymity, speed, and cost are affected by the type of BC and scalability factor. Second answer: like all
technologies, Blockchain is neutral. Unfortunately, corruption is rampant in all sectors of society. There is no reason to expect that it will be any different with Blockchain.
3. The question “What do you think the challenges which need to be addressed for a successful Blockchain implementation for EHRs sharing? (Please select all that apply.)”
49 Figure 12: Blockchain implementation challenges for EHRs sharing
Figure 12 shows the seven possible options that a respondent can choose. In first place, option "Lack of experts skilled in Blockchain technology" had 58
responses. Second place went to options "Blockchains are still an emerging technology" and "Regulatory constraints." Third place options are "Privacy and security considerations," "Lack of understanding just what Blockchain can do/is good for," and "Lack of industry standards." The respondents answered "Don’t know,"
which is the least number, with 20.
Four additional responses were collected from the general public. One:
changing an entire system is expensive, and scalability is still a major challenge for the time being. Two: The challenge will always and forever be bad actors stealing information or using it against people for profit or blackmail. Three: issues in information storage and retrieval: research data management. Finally, four: A security breach is possible as long as I read.
4. The question “Do you think that new regulations are needed to ensure controlled sharing of one’s EHR among parties even when Blockchains are used?”
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Figure 13: The Need for New EHRs Regulations
In Figure 13, 76.2% of respondents agreed on having new regulations to control the EHR’s sharing. where 16.2% did not know if they needed regulations or not, which leaves us with 7.6% that don’t think we need such regulation.
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