Conflated Trust, Misread Loyalty: Disentangling Artefact Trust and Provider Trust in Digital Health

Confiance confondue, fidélité trompeuse: Distinguer la confiance dans le logiciel et la confiance dans son éditeur en santé numérique

Olivier Arsene () and Claudio Vitari ()
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Olivier Arsene: EESC-GEM - Grenoble Ecole de Management
Claudio Vitari: EESC-GEM - Grenoble Ecole de Management

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Abstract: This study examines trust in decentralized digital health by distinguishing two trust objects: the health information technology (HIT) artefact and the Health Software Provider (HSP) organization. Based on 25 semi-structured interviews with self-employed physicians, medical secretaries, and IT support staff in France, we conduct a theory-informed thematic analysis using system trust antecedents (functionality, helpfulness, reliability) and organizational trustworthiness dimensions (competence, benevolence, integrity). Findings show that physicians primarily ground trust in artefact performance and workflow fit, whereas provider trustworthiness is assessed more indirectly through support responsiveness, update strategies, pricing practices, and the translation of regulatory mandates into software defaults. We theorize inscription-based inference as the mechanism through which artefact evolution shapes attributions of provider trustworthiness under opacity and regulation. This explains why continued use can be misread as provider loyalty when artefact and provider trust are conflated, even as organizational trust erodes under high switching costs, informing governance and design choices.

Keywords: Health Information Technology; Self-employed Medicine; Physicians; Operational Trust; Organizational Trust; Healthcare Ecosystem; Digital Health Ecosystem; Technologies de l’information en santé; Écosystème numérique de santé; Écosystème de santé; Confiance organisationnelle; Confiance opérationnelle; Médecins; Médecine libérale (search for similar items in EconPapers)
Date: 2026-05-20
Note: View the original document on HAL open archive server: https://hal.science/hal-05789307v1
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Published in AIM 2026 : 31e conférence de l'Association Information et Management, Haute École spécialisée de Suisse occidentale = HES-SO University of Applied Sciences and Arts Western Switzerland = Fachhochschule Westschweiz [Schweiz] [HES-SO], May 2026, Neuchâtel, Switzerland

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