Patients of EHR-users more likely to withhold information

A provider's use of an electronic health record can cause a patient to clam up for fear that the data won't be secure, according to a new study in the Journal of the American Medical Informatics Association (JAMIA).

The researchers, from the University of Wisconsin-Milwaukee and Dartmouth College, noted that EHRs are a "double-edged sword" in that they're perceived as improving the quality of care but also are seen as having privacy and security risks. Using a nationally representative sample from the 2012 Health Information National Trends Survey, they found that 13 percent of respondents reported having withheld information from their provider because of privacy and security concerns.

The researchers then conducted bivariate and multivariate studies to see if there was a correlation between this non-disclosure and whether the provider used an EHR. The initial bivariate study found no correlation. However, when the researchers factored in the patient's global assessment of quality, there was a positive link between the provider's use of an EHR and the patient's withholding of information.

Patients have become increasingly aware of the privacy and security risks inherent in electronic data. Many of the data breaches of patient protected health information that have been reported to the U.S. Department of Health and Human Services involve electronic data in EHRs and laptops.  Consumers are more likely to support the use and storage of their information in electronic form when they've been assured that it will remain confidential.  

"[O]ur findings suggest that perceived EHR usage may elicit nondisclosure to protect privacy," the researchers said. "Future research should seek to determine whether this association is because patients are concerned about how the EHR is used during clinical visits, or about more general concerns related to the information security of electronic records, or both."

The researchers recommended that providers discuss with patients the benefits of EHRs, as well as privacy and security issues, and to consider how their use of EHRs may affect patient disclosure.

To learn more:
- read the abstract