Adjekum A, Blasimme A, Vayena. (2018). Elements of trust in a digital health systems: Scoping review. Journal of Medical Internet Research. 20(12): e11254. doi: 10.2196/11254
Researchers conducted a scoping literature review to identify factors affecting stakeholder trust in digital health (i.e. stakeholder expectations that digital health will meet their needs). Researchers conducted a literature search for studies exploring stakeholder perspectives of digital health and factors affecting stakeholder trust in digital health. To capture the concept of trust, researchers used related terms, including expectation, mistrust, confidence, and experience. The search resulted in a final pool of 278 articles for review. Studies most often discussed perspectives from patients or the public (n=187) or health care professionals (n=101). Factors that researchers found affected stakeholder trust in digital health fell under the larger concepts of personal elements, technological elements, and institutional elements. Personal elements included perceptions of usefulness (n=110) and ease of use (n=53), sociodemographic factors (e.g., ethnicity, income, educational status; n=84), fair data access (n=21), recommendations from trusted sources (n=17), cost (n=34), accessibility (n=55), and fear of data exploitation (n=25). Technological elements included privacy (n=73), customizable design features (n=28), interoperable systems (n=10), and defective technology (n=32). Institutional elements affecting trust included stakeholder engagement (n=71), expectations of improved communication (n=46) and decreased workload (n=82), face-to-face interactions prior to implementation (n=40), reputation of service providers (n=71), time-commitment required (n=42), information quality (n=51), quality of training (n=54), publicity (n=44), and presence of guidelines for use (n=22).