Appl Clin Inform 2016; 07(04): 983-993
DOI: 10.4338/ACI-2016-07-RA-0107
Research Article
Schattauer GmbH

Improving Individual Acceptance of Health Clouds through Confidentiality Assurance

Tatiana Ermakova
1  Business Informatics, esp. Social Media and Data Science, University of Potsdam, Germany
Benjamin Fabian
2  Business Intelligence und Data Science, Hochschule fur Telekommunikation Leipzig, Leipzig, Sachsen, Germany
Rüdiger Zarnekow
3  Department of Information and Communication Management, Technical University of Berlin, Germany
› Author Affiliations
Funding The work presented in this paper was performed to support the TRESOR research project, which is funded by the German Federal Ministry of Economic Affairs and Energy under grant number 01MD11062.
Further Information

Publication History

received: 03 July 2016

accepted: 12 September 2016

Publication Date:
18 December 2017 (online)


Background Cloud computing promises to essentially improve healthcare delivery performance. However, shifting sensitive medical records to third-party cloud providers could create an adoption hurdle because of security and privacy concerns.

ObjectivesThis study examines the effect of confidentiality assurance in a cloud-computing environment on individuals’ willingness to accept the infrastructure for inter-organizational sharing of medical data.

MethodsWe empirically investigate our research question by a survey with over 260 full responses. For the setting with a high confidentiality assurance, we base on a recent multi-cloud architecture which provides very high confidentiality assurance through a secret-sharing mechanism: Health information is cryptographically encoded and distributed in a way that no single and no small group of cloud providers is able to decode it.

ResultsOur results indicate the importance of confidentiality assurance in individuals’ acceptance of health clouds for sensitive medical data. Specifically, this finding holds for a variety of practically relevant circumstances, i.e., in the absence and despite the presence of conventional offline alternatives and along with pseudonymization. On the other hand, we do not find support for the effect of confidentiality assurance in individuals’ acceptance of health clouds for non-sensitive medical data. These results could support the process of privacy engineering for health-cloud solutions.

Citation: Ermakova T, Fabian B, Zarnekow R. Improving individual acceptance of health clouds through confidentiality assurance.