Supporting Cybersecurity-Aware Technology Adoption Decision-Making among Patients in an Increasingly Complex Digital Health Ecosystem
Professor Tera Reynolds
UMBC Department of Information Systems
12–1 pm ET, Friday, April 10, 2026, online
The 21st Century Cures Act has expanded patient access to medical records and enabled certified electronic health record systems to share data with “trusted” mobile health applications via APIs, allowing patients to cultivate personalized micro-ecosystems of health technologies within a broader digital health ecosystem that includes tools like large language models and wearable devices. While this interconnected ecosystem has the potential to support patient self-management, it also introduces a more complex cybersecurity landscape, with limited understanding of how healthcare organizations define “trusted” apps or how patients navigate related risks. In this study, we combined a literature review with interviews with two health IT professionals and 25 patients with complex care needs to examine cybersecurity risks and decision-making across the digital health ecosystem. Our findings highlight emerging themes in how healthcare systems determine trusted apps, monitor threats, and communicate risks, as well as how patients form mental models of cybersecurity, weigh trade-offs when adopting technologies, and vary in their risk tolerance—often perceiving cybersecurity as a constantly evolving challenge that requires ongoing vigilance or avoiding health technologies altogether. These insights underscore the need for better support in navigating cybersecurity decisions and inform our ongoing work to co-design a personalized decision aid to help patients make informed, risk-aligned choices about health technology use.
Tera Reynolds takes a socio-technical lens to understand how we can improve the design and implementation of technologies that connect, facilitate interaction, and support the independent and collaborative health work of individuals (e.g., patients, general public/citizens) and health professionals (e.g., doctors, public health practitioners). Examples of such technologies include patient portals, Apple Health Records, and COVID-19 Contact Tracing applications. She is particularly interested in examining how we can mitigate the risk of these technologies exacerbating health disparities by providing another advantage to already advantaged groups (referred to as intervention-generated inequalities or digital health disparities).
Host: Dr. Alan T. Sherman. Support for this event was provided in part by the NSF under SFS grants DGE-1753681 and 2438185.