Abstract

BackgroundRobust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers’ views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers’ willingness to share electronic health information for healthcare and research.MethodsThis study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant (p-value ≤ 0.05) associations of each explanatory variable with the outcome variable.ResultsThe odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio (OR) = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46–0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94].ConclusionsConsumers’ choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems.

Highlights

  • Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost

  • The survey was developed from themes that arose from patient focus groups and previously published surveys including items related to privacy, security, Health information exchange (HIE), electronic health record (EHR), and health research and underwent cognitive testing before being fielded

  • HIE consent was addressed with the question “If you were offered the choice to have your medical information automatically shared electronically with the different places where you receive medical care, how likely would you be to agree to it?” The research consent question was “Some medical research studies use information that is already in electronic medical records

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Summary

Introduction

Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. The expansion and improvement of electronic health records (EHRs) has become a national priority and is described as “foundational to achieve the nation’s health and wellness goals [1]” To promote this goal the 2009 Health Information Technology for Economic and Clinical Health act (HITECH) allocated 35 billion dollars to incentivize the development and implementation of electronic health record (EHR) systems for all healthcare. In addition to informing patient care, this data must support quality improvement and research

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