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The double-edged sword of electronic health records: implications for patient disclosure.
J Am Med Inform Assoc. 2015 Apr; 22(e1):e130-40.JAMIA

Abstract

OBJECTIVE

Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients' global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure.

MATERIALS AND METHODS

A nationally representative sample from the 2012 Health Information National Trends Survey was analyzed using bivariate and multivariable logit regressions to examine whether global ratings of care suppress the relationship between EHR provider-use and patient non-disclosure.

RESULTS

13% of respondents reported having ever withheld information from a provider because of privacy/security concerns. Bivariate analysis showed that withholding information was unrelated to whether respondents' providers used an EHR. Multivariable analysis showed that accounting for respondents' global ratings of care revealed a positive relationship between having a provider who uses an EHR and withholding information.

DISCUSSION

After accounting for global ratings of care, findings suggest that patients may non-disclose to providers to protect against the perceived EHR privacy and security risks. Despite evidence that EHRs inhibit patient disclosure, their advantages for promoting quality of care may outweigh the drawbacks.

CONCLUSIONS

Clinicians should leverage the EHR's value in quality of care and discuss patients' privacy concerns during clinic visits, while policy makers should consider how to address the real and perceived privacy and security risks of EHRs.

Authors+Show Affiliations

Department of Sociology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.Department of Sociology, Institute for Security, Technology, and Society, Dartmouth College, Hanover, New Hampshire, USA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

25059953

Citation

Campos-Castillo, Celeste, and Denise L. Anthony. "The Double-edged Sword of Electronic Health Records: Implications for Patient Disclosure." Journal of the American Medical Informatics Association : JAMIA, vol. 22, no. e1, 2015, pp. e130-40.
Campos-Castillo C, Anthony DL. The double-edged sword of electronic health records: implications for patient disclosure. J Am Med Inform Assoc. 2015;22(e1):e130-40.
Campos-Castillo, C., & Anthony, D. L. (2015). The double-edged sword of electronic health records: implications for patient disclosure. Journal of the American Medical Informatics Association : JAMIA, 22(e1), e130-40. https://doi.org/10.1136/amiajnl-2014-002804
Campos-Castillo C, Anthony DL. The Double-edged Sword of Electronic Health Records: Implications for Patient Disclosure. J Am Med Inform Assoc. 2015;22(e1):e130-40. PubMed PMID: 25059953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The double-edged sword of electronic health records: implications for patient disclosure. AU - Campos-Castillo,Celeste, AU - Anthony,Denise L, Y1 - 2014/07/24/ PY - 2014/03/17/received PY - 2014/07/14/accepted PY - 2014/7/26/entrez PY - 2014/7/26/pubmed PY - 2016/2/24/medline KW - consumer surveys KW - electronic health records KW - patient-doctor communication KW - privacy KW - quality of care SP - e130 EP - 40 JF - Journal of the American Medical Informatics Association : JAMIA JO - J Am Med Inform Assoc VL - 22 IS - e1 N2 - OBJECTIVE: Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients' global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure. MATERIALS AND METHODS: A nationally representative sample from the 2012 Health Information National Trends Survey was analyzed using bivariate and multivariable logit regressions to examine whether global ratings of care suppress the relationship between EHR provider-use and patient non-disclosure. RESULTS: 13% of respondents reported having ever withheld information from a provider because of privacy/security concerns. Bivariate analysis showed that withholding information was unrelated to whether respondents' providers used an EHR. Multivariable analysis showed that accounting for respondents' global ratings of care revealed a positive relationship between having a provider who uses an EHR and withholding information. DISCUSSION: After accounting for global ratings of care, findings suggest that patients may non-disclose to providers to protect against the perceived EHR privacy and security risks. Despite evidence that EHRs inhibit patient disclosure, their advantages for promoting quality of care may outweigh the drawbacks. CONCLUSIONS: Clinicians should leverage the EHR's value in quality of care and discuss patients' privacy concerns during clinic visits, while policy makers should consider how to address the real and perceived privacy and security risks of EHRs. SN - 1527-974X UR - https://www.unboundmedicine.com/medline/citation/25059953/The_double_edged_sword_of_electronic_health_records:_implications_for_patient_disclosure_ L2 - https://academic.oup.com/jamia/article-lookup/doi/10.1136/amiajnl-2014-002804 DB - PRIME DP - Unbound Medicine ER -