User Trust and Perception of Cryptographic Technologies in Centralized Electronic Health Record Systems: A Random Forest Analysis

Abstract

This study examines user trust and perception of cryptographic technologies specifically SHA3-512 hashing, SERPENT encryption, and Zero-Knowledge Proofs (ZKP) in the context of centralized Electronic Health Record (EHR) systems. As healthcare institutions increasingly migrate patient data to digital platforms, the security and privacy properties of underlying cryptographic mechanisms have become critical determinants of user confidence and system adoption. Using a quantitative, survey-based design, data were collected from 92 healthcare practitioners, IT professionals, and system administrators actively engaged with EHR systems in Auchi, Nigeria. A Random Forest classifier was trained to predict perceived satisfaction levels (Low, Neutral, High) based on respondents' assessments of cryptographic effectiveness, usability, and trust. Results indicate that trust in ZKP is the strongest predictor of overall perception, followed by confidence in SERPENT encryption and SHA3-512 integrity guarantees. The model achieved a classification accuracy of 63.3% on a held-out test set derived from this exploratory sample, with a Kappa statistic of 0.52 reflecting moderate agreement beyond chance. Balanced accuracy across classes (approximately 0.49–0.50) and low per class sensitivity confirm that the findings should be interpreted as preliminary and directional rather than definitive. Key themes from open ended feedback analyzed using TF-IDF text mining reveal that while respondents broadly recognize the security value of these cryptographic mechanisms, concerns about system slowdown, usability complexity, and insufficient user education present barriers to wider adoption. This study contributes a pilot-level empirical baseline for understanding stakeholder perception of layered cryptographic security in resource-constrained healthcare environments, and highlights the need for larger-scale replication studies.

Keywords: SHA3-512; SERPENT encryption; Zero-Knowledge Proofs; healthcare data security; user perception; Electronic Health Records; Random Forest