Digital Health Information System Research Articles

Early Effects of Information Revolution Interventions on Health Information System Performance in Ethiopia.

Health information systems (HISs) are essential to a country's health system as they provide critical support to health policymaking, management, financing, and service delivery. A well-functioning HIS should produce timely and reliable data that are available and easily accessible to decision-makers throughout the health system. Ethiopia has transitioned from a fragmented, paper-based health management information system (HMIS) to a harmonized, digital system used at points of collection and service delivery.In 2016, the Federal Ministry of Health (MOH) launched the Information Revolution (IR), a transformative agenda aimed at enhancing the culture of data use, scaling priority HIS tools and systems, and strengthening HIS governance. Between 2016 and 2022, the MOH, Data Use Partnership, and other partners implemented a series of IR interventions that supported this agenda. These interventions included deploying and harmonizing digital HIS systems; strengthening HIS leadership, coordination, and governance; implementing the IR pathway strategy; enhancing capacity through supportive supervision, mentorship, and training; and improving performance monitoring teams. This article aims to synthesize the key HIS interventions implemented in Ethiopia as part of the IR and document the effects of these interventions on HIS performance.Early studies indicate promising improvements in HIS performance across health facilities in Ethiopia. However, challenges remain. To ensure sustainable progress, it is essential to continue addressing key challenges, such as system interoperability, HIS workforce, and capacity for data use at all levels. By building on the successes of the first Health Sector Transformation Plan and addressing these gaps, Ethiopia can advance its vision of a robust, data-driven health system capable of improving health outcomes and driving evidence-based decision-making.

“Design of a Trustworthy Cloud-Native National Digital Health Information Infrastructure for Secure Data Management and Use”

Abstract Since 2022, Malawi Ministry of Health (MoH) designated the development of a National Digital Health Information System (NDHIS) as one of the most important pillars of its national health strategy. This system is built upon a distributed computing infrastructure employing the following state-of-art technologies: (1) digital healthcare devices to capture medical data; (2) Kubernetes-based Cloud-Native Computing architecture to simplify system management and service deployment; (3) Zero-Trust Secure Communication to protect confidentiality, integrity and access rights of medical data transported over the Internet; (4) Trusted Computing to allow medical data to be processed by certified software without compromising data privacy and sovereignty. Trustworthiness, including reliability, security, privacy and business integrity, of this system was ensured by a peer-to-peer network of trusted medical information guards deployed as the gatekeepers of every computing node on this system. This NDHIS shall facilitate Malawi to attain universal health coverage by 2030 through its scalability and operation efficiency. It shall improve medical data quality and security by adopting a paperless approach. It will also enable MoH to offer data rental services to healthcare researchers and AI model developers around the world. This project is spearheaded by the Digital Health Division (DHD) under MoH. The trustworthy computing infrastructure was designed by a taskforce assembled by the DHD in collaboration with Luke International in Norway, and a consortium of hardware and software solution providers in Taiwan. A prototype that can connect community clinics with a district hospital has been tested at the Taiwan Pingtung Christian Hospital.

Partnering With Nurse Inventors and Entrepreneurs: A Guide for Nursing Professional Development Leaders.

Health care innovation and entrepreneurship are key drivers of transformation in health care, re-shaping the way care is delivered, managed, and experienced. Innovation in health care spans a range of areas, including digital health, bio-technology, medical devices, tele-health, and health information systems. Entrepreneurs are leveraging technology to create solutions to improve patient outcomes, reduce costs, and address inefficiencies. Nurse inventors and entrepreneurs are blazing new trails that require nursing professional development leaders to consider new opportunities for collaboration. For nursing professional development leaders, fostering relationships with nurse entrepreneurs can unlock numerous benefits, from improving patient safety to enhancing nursing practice and facilitating advisory board appointments. [J Contin Educ Nurs. 2024;55(11):517-519.].

Enhancing Healthcare Information Systems in Ethiopian Hospitals: Exploring Challenges and Prospects of a Cloud-based Model for Smart and Sustainable Information Services

Hospitals are the primary hubs for healthcare service providers in Ethiopia; however, hospitals face significant challenges in adopting digital health information systems solutions due to disparate, non-interoperable systems and limited access. Information technology, especially via cloud computing, is crucial in healthcare for efficient data management, secure storage, real-time access to critical information, seamless provider communication, enhanced collaboration, and scalable IT infrastructure. This study investigated the challenges to standardizing smart and green healthcare information services and proposed a cloud-based model for overcoming them. We conducted a mixed-methods study in 11 public hospitals, employing quantitative and qualitative approaches with diverse stakeholders (N = 103). The data was collected through surveys, interviews, and technical observations by purposive quota sampling with the Raosoft platform and analyzed using IBM SPSS. Findings revealed several shortcomings in existing information systems, including limited storage, scalability, and security; impaired data sharing and collaboration; accessibility issues; no interoperability; ownership ambiguity; unreliable data recovery; environmental concerns; affordability challenges; and inadequate policy enforcement. Notably, hospitals lacked a centralized data management system, cloud-enabled systems for remote access, and modern data recovery strategies. Despite these challenges, 90.3% of respondents expressed interest in adopting cloud-enabled data recovery systems. However, infrastructure limitations, inadequate cloud computing/IT knowledge, lack of top management support, digital illiteracy, limited innovation, and data security concerns were identified as challenges to cloud adoption. The study further identified three existing healthcare information systems: paper-based methods, electronic medical catalog systems, and district health information systems2. Limitations of the paper-based method include error-proneness, significant cost, data fragmentation, and restricted remote access. Growing hospital congestion and carbon footprint highlighted the need for sustainable solutions. Based on these findings, we proposed a cloud-based model tailored to the Ethiopian context. This six-layered model, delivered as a Software-as-a-Service within a community cloud deployment, aims to improve healthcare services through instant access, unified data management, and evidence-based medical practices. The model demonstrates high acceptability and potential for improving healthcare delivery, and implementation recommendations are suggested based on the proposed model.

Gender Harmony: A Case for Nursing Informatics.

The design of digital health information systems around a conflated gender/sex binary contributes to health inequities. Lack of specific information that supports affirming communication lead to inappropriate care, disrespectful encounters with healthcare staff, and avoidance of health services by clients who have been harmed by misgendering, deadnaming and being outed. The HL7 International Gender Harmony Model (HL7 GHM) supports the design, implementation and use of DHIS that enable affirming clinical interactions and care. This case study will demonstrate how applying the HL7 GHM can address the harms reported in a recently published account of one patient in Canada.

Indian Digital Health Information Systems: Initiatives and Opportunities with Socio-economic Perspective

"Digital technologies have emerged as indispensable tools in designing and developing sophisticated healthcare systems. In today’s world, human society is deeply intertwined with digital technologies and computing. Advancements in communication and technology have greatly enhanced global connectivity among people and stakeholders. Organisations and institutions across various sectors, including healthcare and medicine, increasingly embrace technology. Governments worldwide are actively promoting the integration of IT and computing into healthcare and medical systems. Utilising different technologies and computing subfields has developed advanced, intelligent, and more efficient healthcare services. Digital healthcare is pivotal in promoting enhanced well-being for individuals of all ages, irrespective of location. To advance healthcare infrastructure, national, state, or regional digital health initiatives have been implemented with comprehensive strategies encompassing financial, organisational, human, and technological resources. InIndia, several initiatives have been launched in the healthcare sector, focusing on technology and computing. This paper explores various aspects of technology and computing in healthcare, providing insights into digital healthcare informatics’s existing, current, and future scenarios. It examines adopted and potential strategies to enhance healthcare delivery through integrating digital technologies and computing systems. This paper is a conceptual works and its includes the detailed study of the secondary data source collected from different government websites and digital platforms and then analyzing these qualitative and quantitative data to understand the issues related to digital healthcare system."

Intention to Use an Electronic Community Health Information System Among Health Extension Workers in Rural Northwest Ethiopia: Cross-Sectional Study Using the Unified Theory of Acceptance and Use of Technology 2 Model.

IT has brought remarkable change in bridging the digital gap in resource-constrained regions and advancing the health care system worldwide. Community-based information systems and mobile apps have been extensively developed and deployed to quantify and support health services delivered by community health workers. The success and failure of a digital health information system depends on whether and how it is used. Ethiopia is scaling up its electronic community health information system (eCHIS) to support the work of health extension workers (HEWs). For successful implementation, more evidence was required about the factors that may affect the willingness of HEWs to use the eCHIS. This study aimed to assess HEWs' intentions to use the eCHIS for health data management and service provision. A cross-sectional study design was conducted among 456 HEWs in 6 pilot districts of the Central Gondar zone, Northwest Ethiopia. A Unified Theory of Acceptance and Use of Technology model was used to investigate HEWs' intention to use the eCHIS. Data were cleaned, entered into Epi-data (version 4.02; EpiData Association), and exported to SPSS (version 26; IBM Corp) for analysis using the AMOS 23 Structural Equation Model. The statistical significance of dependent and independent variables in the model was reported using a 95% CI with a corresponding P value of <.05. A total of 456 HEWs participated in the study, with a response rate of 99%. The mean age of the study participants was 28 (SD 4.8) years. Our study revealed that about 179 (39.3%; 95% CI 34.7%-43.9%) participants intended to use the eCHIS for community health data generation, use, and service provision. Effort expectancy (β=0.256; P=.007), self-expectancy (β=0.096; P=.04), social influence (β=0.203; P=.02), and hedonic motivation (β=0.217; P=.03) were significantly associated with HEWs' intention to use the eCHIS. HEWs need to be computer literate and understand their role with the eCHIS. Ensuring that the system is easy and enjoyable for them to use is important for implementation and effective health data management.

Developing a patient flow visualization and prediction model using aggregated data for a healthcare network cluster in Southwest Ethiopia.

A health information system has been created to gather, aggregate, analyze, interpret, and utilize data collected from diverse sources. In Ethiopia, the most popular digital tools are the Electronic Community Health Information System and the District Health Information System. However, these systems lack capabilities like real-time interactive visualization and a data-driven engine for evidence-based insights. As a result, it was challenging to observe and continuously monitor the flow of patients. To address the gap, this study used aggregated data to visualize and predict patient flow in a South Western Ethiopia healthcare network cluster. The South-Western Ethiopian healthcare network cluster was where the patient flow datasets were collected. The collected dataset encompasses a span of 41 months, from 2019 to 2022, and has been obtained from 21 hospitals and health centers. Python Sankey diagrams were used to develop and build patient flow visualizations. Then, using the random forest and K-Nearest Neighbors (KNN) algorithms, we achieved an accuracy of 0.85 and 0.83 for the outpatient flow modeling and prediction, respectively. The imbalance in the data was further addressed using the NearMiss Algorithm, Synthetic Minority Oversampling Technique (SMOTE), and SMOTE-Tomek methods. In conclusion, we developed a patient flow visualization and prediction model as a first step toward an end-to-end effective real-time patient flow data-driven and analytical dashboard in Ethiopia, as well as a plugin for the already-existing digital health information system. Moreover, the need for and amount of data created by these digital tools will grow along with their use, demanding effective data-driven visualization and prediction to support evidence-based decision-making.

Exploring the barriers and facilitators to implementing electronic health records in a middle-income country: a qualitative study from South Africa.

As more countries are moving towards universal health care, middle-income countries in particular are trying to expand coverage, often using public funds. Electronic health records (EHR) are useful in monitoring patient outcomes, the performance of providers, and so the use of those public funds. With the multiple institutions or departments responsible for providing care to any individual, rather than a single record, an EHR is the interface through which to view data from a digital health information eco-system that draws on data from many different sources. South Africa plans to establish a National Health Insurance fund where EHRs will be essential for monitoring outcomes, and informing purchasing decisions. Despite various relevant policies and South Africa's relative wealth and digital capability, progress has been slow. In this paper, we explore the barriers and facilitators to implementing electronic health records in South Africa. In this qualitative study, we conducted in-depth interviews with participants including academics, staff at parastatals, managers in the private health sector, NGO managers and government staff at various levels. The Western Cape provincial government over a 20-year period has managed to develop a digital health information ecosystem by drawing together existing data systems and building new systems. However, despite having the necessary policies in place and a number of stand-alone population level digital health information systems, several barriers still stand in the way of building national electronic health records and an efficient digital health ecosystem. These include a lack of national leadership and conflict, a failure to understand the scope of the task required to achieve scale up, insufficient numbers of technically skilled staff, failure to use the tender system to generate positive outcomes, and insufficient investment towards infrastructural needs such as hardware, software and connectivity. For South Africa to have an effective electronic health record, it is important to start by overcoming the barriers to interoperability, and to develop the necessary underlying digital health ecosystem. Like the Western Cape, provincial governments need to integrate and build on existing systems as their next steps forward.

Introducing digital health information systems in post-conflict Mozambique: a historical perspective

ABSTRACT The institutional dynamics around digital Health Information Systems implementations are subject to influences from the technological artefacts themselves or contextual conditions from the setting. These not always obvious and easily visible, appearing intrinsically hidden, may only be made perceptible through analysing patterns across a historical timeframe. Recognizing history’s potential, both as a tool and a means for enabling this analysis, we seek to build a situated understanding of the technology adoption and institutionalization processes, valuable to support future implementation efforts. This analysis is conducted as a historical study based on implementing a digital platform for public health management in Mozambique, a low- and middle-income country recovering from the aftermath of colonial rule and violent civil war. While the overall study spans twenty years since 2000, this paper focuses on the first seven years to identify institutional contradictions and how these shaped the adoption and evolution of digitally based systems processes.

Digital Health Information Systems in the Member States of the Commonwealth of Independent States: Status and Prospects

This paper examines the status of the development of national digital health information systems (HIS) in Commonwealth of Independent States (CIS) member states. Data for research were collected using a questionnaire adapted from the questionnaire of the WHO’s Third Global Survey on eHealth. The results showed that the digital transformation of HIS was occurring in all seven CIS member states (participating in the study), which were financed by different resources. Laws and regulations on electronic medical records (EMR) use were present in almost all participating CIS member states. Various international standards and classifications were used to support development and the interoperability of digital health information system (d-HIS), including International Classification of Diseases (ICD), Digital Imaging and Communications in Medicine (DICOM), ISO 18308, Logical Observation Identifiers, Names, and Codes (LOINC), Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), and ISO TC 215. Several CIS member states had adopted a national information security strategy for the safe processing of both personal data and medical confidential information. The digital transformation of healthcare and the Empowerment through Digital Health initiative are taking place in all CIS member states, which are at different stages of introducing electronic medical and health records.

Vulnerability to Cyberattacks and Sociotechnical Solutions for Health Care Systems: Systematic Review.

Health care organizations worldwide are faced with an increasing number of cyberattacks and threats to their critical infrastructure. These cyberattacks cause significant data breaches in digital health information systems, which threaten patient safety and privacy. From a sociotechnical perspective, this paper explores why digital health care systems are vulnerable to cyberattacks and provides sociotechnical solutions through a systematic literature review (SLR). An SLR using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted by searching 6 databases (PubMed, Web of Science, ScienceDirect, Scopus, Institute of Electrical and Electronics Engineers, and Springer) and a journal (Management Information Systems Quarterly) for articles published between 2012 and 2022 and indexed using the following keywords: "(cybersecurity OR cybercrime OR ransomware) AND (healthcare) OR (cybersecurity in healthcare)." Reports, review articles, and industry white papers that focused on cybersecurity and health care challenges and solutions were included. Only articles published in English were selected for the review. In total, 5 themes were identified: human error, lack of investment, complex network-connected end-point devices, old legacy systems, and technology advancement (digitalization). We also found that knowledge applications for solving vulnerabilities in health care systems between 2012 to 2022 were inconsistent. This SLR provides a clear understanding of why health care systems are vulnerable to cyberattacks and proposes interventions from a new sociotechnical perspective. These solutions can serve as a guide for health care organizations in their efforts to prevent breaches and address vulnerabilities. To bridge the gap, we recommend that health care organizations, in partnership with educational institutions, develop and implement a cybersecurity curriculum for health care and intelligence information sharing through collaborations; training; awareness campaigns; and knowledge application areas such as secure design processes, phase-out of legacy systems, and improved investment. Additional studies are needed to create a sociotechnical framework that will support cybersecurity in health care systems and connect technology, people, and processes in an integrated manner.

Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.

Recent technological and radiological advances have renewed interest in using X-rays to screen and triage people with tuberculosis (TB). The miniaturization of digital X-ray (DXR), combined with automatic interpretation using computer-aided detection (CAD) software can extend the reach of DXR screening interventions for TB. This qualitative study assessed early implementers' experiences and lessons learned when using ultra-portable (UP) DXR systems integrated with CAD software to screen and triage TB. Semi-structured interviews were conducted with project staff and healthcare workers at six pilot sites. Transcripts were coded and analyzed using a framework approach. The themes that emerged were subsequently organized and presented using the Consolidated Framework for Implementation Research (CFIR). There were 26 interviewees with varying roles: supervisory, clinicians, radiographers, and radiologists. Participants recognized the portability as the main advantage, but criticize that it involves several compromises on throughput, internet dependence, manoeuvrability, and stability, as well as suitability for patients with larger body sizes. Furthermore, compared to using hardware and software from the same supplier and without digital health information systems, complexity increases with interoperability between hardware and software, and between different electronic health information systems. Currently, there is a limited capacity to implement these technologies, especially due to the need for threshold selection, and lack of guidance on radiation protection suitable for UP DXR machines. Finally, the respondents stressed the importance of having protected means of sharing patient medical data, as well as comprehensive support and warranty plans. Study findings suggest that UP DXR with CAD was overall well received to decentralize radiological assessment for TB, however, the improved portability involved programmatic compromises. The main barriers to uptake included insufficient capacity and lack of guidance on radiation protection suitable for UP DXR.

Digital health systems-let's talk about sex (and gender).

Historically, within digital health information systems, sex and gender have been conflated as a single concept and often have been limited to a binary answer. This has led to inappropriate care, erosion of client trust and avoidance of the healthcare system. Health leaders can improve care for all clients with technical and clinical information practice initiatives. While procurement processes could require digital health systems that utilize modern Gender, Sex, and Sexual Orientation (GSSO) terminology, for most health leaders, technical initiatives will focus on modernizing existing systems to the maximum extent possible. Terminology updates may not be immediately visible to clients, but providing the correct information to clinicians will support respectful client encounters. Simultaneously, clinical information practice initiatives can directly affect clinical encounters. Change management strategies need to include all levels of employees and redesign tools and workflows to support modernized information handling practices.

Understanding Users' Continuance Usage Behavior Towards Digital Health Information System Driven by the Digital Revolution Under COVID-19 Context: An Extended UTAUT Model.

BackgroundImproving the health status of users through the use of digital health information systems has drawn the attention of practitioners and academics under the tide of the digital revolution, specifically in the time of global pandemic of COVID-19, and as a result, online medical consultation has developed rapidly.PurposeEmpirical studies, however, are lacking in terms of gaining insight into use digital health information system driven by the digital revolution under COVID-19 and identifying the factors for retaining users and encouraging their continuing use. To solve this problem, this study seeks to explore the factors that influence users’ intention to use digital health information system.MethodsThis study extended the Unified Theory of Acceptance and Use of Technology (UTAUT) model by introducing components of perceived risks into the model. Structural equation modeling was adopted to evaluate the research model based on an empirical survey of 241 users in China.ResultsAs indicated by the results, users’ continuance usage behavior to digital health information system is shaped by intention to use and facilitating conditions, with effort expectancy, social influence, perceived ease of use and perceived enjoyment exerting indirect positive effects on continuance usage behavior via intention to use. In contrast, perceived risk and perceived cost have indirect negative impact on continuance usage behavior.ConclusionThe findings of this study can not only help the practitioners better understand the users’ continuance usage behavior towards digital health information system driven by digital revolution in the time of COVID-19 pandemic and further tap into the potential market but also make up the short of traditional technology acceptance model explanatory by the extended UTAUT model.

Experiences and expectation with the use of health data: a qualitative interview study in primary care

BackgroundHealth data is important, however, not always well managed. The aim of this study was to investigate the experiences of patients and primary care physicians, their expectations and the obstacles encountered when using health data – both patient-generated as well as physician-generated.MethodsWe conducted a qualitative interview study. We included adult persons who were ready to talk about the topic. Participants were recruited from primary care. The interviews were recorded using a dictaphone, transcribed verbatim and analysed using a content analysis method.ResultsAltogether, we conducted 14 individual interviews, with patients (n = 7) and with physicians (n = 7). We found that both patients and physicians emphasized the importance of easy access to health data in digital health information systems. However, patients may not always understand medical terminology and physicians found that the quality of medical documents needs inspection. Both parties found that patient-generated data is a useful source of information, and that it should be used more often.ConclusionsThe pandemic has highlighted the value of easy access to health data. The development of a health information system is useful to health care providers and patients, enables the transfer of evidence-based medicine, and supports health literacy.

The Gap Between Technology and Ethics, Especially in Low- and Middle-Income Country Health Information Systems: A Bibliometric Study.

Digital health information systems are quickly replacing paper systems worldwide. This study examined scholarly work reflecting how ethical considerations for health information systems (HISs) have evolved over time, with particular interest in the contributions from low- and middle-income country (LMIC) institutions. We systematically searched four research databases for terms related to HISs, ethics, and LMICs; and identified 601 relevant articles published from 1975 through 2019. The included publications were produced by 1,000 authors from more than 700 institutions. However, only 30 publications were co-authored by researchers from both an LMIC and a high-income country (HIC). Most publications pertained to data security. There is an acute need to address a wider array of HIS ethics topics, including those that may be unique to LMIC resource constraints. We recommend more collaborations between LMIC and HIC institutions to address the full range of HIS ethical concerns in LMICs.

HL7 FHIR with SNOMED-CT to Achieve Semantic and Structural Interoperability in Personal Health Data: A Proof-of-Concept Study.

Heterogeneity is a problem in storing and exchanging data in a digital health information system (HIS) following semantic and structural integrity. The existing literature shows different methods to overcome this problem. Fast healthcare interoperable resources (FHIR) as a structural standard may explain other information models, (e.g., personal, physiological, and behavioral data from heterogeneous sources, such as activity sensors, questionnaires, and interviews) with semantic vocabularies, (e.g., Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT)) to connect personal health data to an electronic health record (EHR). We design and develop an intuitive health coaching (eCoach) smartphone application to prove the concept. We combine HL7 FHIR and SNOMED-CT vocabularies to exchange personal health data in JavaScript object notion (JSON). This study explores and analyzes our attempt to design and implement a structurally and logically compatible tethered personal health record (PHR) that allows bidirectional communication with an EHR. Our eCoach prototype implements most PHR-S FM functions as an interoperability quality standard. Its end-to-end (E2E) data are protected with a TSD (Services for Sensitive Data) security mechanism. We achieve 0% data loss and 0% unreliable performances during data transfer between PHR and EHR. Furthermore, this experimental study shows the effectiveness of FHIR modular resources toward flexible management of data components in the PHR (eCoach) prototype.

Maturity assessment of Kenya’s health information system interoperability readiness

BackgroundThe use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health...

Some legal issues of medical privacy in psychiatric practice

The article discusses a number of issues associated with medical privacy in psychiatry, including forensic psychiatric evaluation. Current Law of the Russian Federation “On Psychiatric Care and Guarantees of Citizens’ Rights in Its Provision” requires taking into account the mental state of a person with a mental disorder when informing him about his mental health condition. However this rule misses new realities of digital health and is not included into the legislation on protection of citizens’ health. It is hardly possible to realize in practice and it needs an additional and established by law mechanism of access to medical records, considering specific properties of psychiatric patients. Problems also arise with a mentally disordered person&amp;apos;s access to his forensic psychiatric medical record. On the one hand, the report of forensic psychiatric evaluation is an evidence in the court case, and the procedure for its disclosure is regulated by procedural legislation and legislation on state forensic expert activities. On the other hand, the Constitutional Court of the Russian Federation considers such a report as a medical document, for which the rules of legislation on protection of citizens’ health apply. In this paper the authors propose the solution to this dilemma that requires corrections in the position of the Constitutional Court of the Russian Federation. The authors analyze the history of legislation on medical privacy and draw attention to obvious long-term trend that shows in continuing expansion of the range of persons who have right to access such information without consent of the citizen concerned. The authors conclude that medical privacy is gradually losing the nature of the right guaranteed by federal law. Especially worrying are the attempts of a number of state bodies and officials to obtain information about mental health of unspecified groups of people. Too many third parties already have access to medical information for various reasons, and the number is growing with introduction of digital health information systems. The authors come to conclusion that such a development can lead to serious negative consequences for the legally guaranteed rights of citizens and stress the importance of special attention to protection of medical information, including measures against unlawful access and possible leaks.