Unpacking the complexities of health record misuse: insights from Australian health services

PurposeInformation systems (IS) research in general and health IS studies, in particular, are prone to a positivity bias – largely focusing on upside gains rather than the potential misuse practices. This paper aims to explore failures in health IS use and shortcomings in data privacy and cybersecurity and to provide an explanatory model for health record misuse.Design/methodology/approachThis research is based on four data sets that we collected through a longitudinal project studying digital health (implementation, use and evaluation), interviews with experts (cybersecurity and digital health) and healthcare stakeholders (health professionals and managers). We applied qualitative analysis to explain health records misuse from a sociotechnical perspective.FindingsWe propose a contextualized model of “health records misuse” with two overarching dimensions: data misfit and improper data processing. We explain sub-categories of data misfit: availability misfit, meaning misfit and place misfit, as well as sub-categories of improper data processing: improper interaction and improper use-related actions. Our findings demonstrate how health records misuse can emerge in sociotechnical health systems and impact health service delivery and patient safety.Originality/valueThrough contextualizing system misuse in healthcare, this research advances the understanding of ineffective use and failures in health data protection practices. Our proposed theoretical model provides explanations for unique patterns of IS misuse in healthcare, where data protection failures are consequential for healthcare organizations and patient safety.