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Table 3 Open codes for problems with existing HIE mechanisms used for information sharing

From: Benefits and concerns associated with blockchain-based health information exchange (HIE): a qualitative study from physicians' perspectives

Open codes

Common concept

Mainly focusing on EHRs, downtime issues, EHR-based exchange, not compatible EHRs, lack of standards, reliability of EHR systems, interoperability issues of uncertified EHRs

EHR-focused exchange

Centralization, central ownership, centralized authority, managed by a middleman

Centralized mechanism

lack of patient-provider interactions, lack of support for care coordination, delays in care delivery

Care coordination

Not transparent, fuzzy purposes of sharing, unclear permission process, lack of visibility of sharing process, ambiguous ownership transfer

Transparency of sharing mechanisms

Privacy concerns, security issues, data breach, a single point of failure, technical security measures

Privacy and security

Data are outdated in HIE databases, unavailability of patient data, incomplete or inaccurate patient information is stored in shared records, lack of real-time access to patient data, data inconsistency, duplicate data

Data quality

Trust issues, trust in recipients, trust-based systems, trust in networks

Trust

Data can be altered, medical records can be manipulated, information can be removed by any entities participating in HIE initiatives

Mutability