Trust Me, I'm a Doctor: Examining Changes in How Privacy Concerns Affect Patient Withholding Behavior.

Daniel M Walker,Timothy R Huerta,Tyler Johnson,Eric W Ford

doi:10.2196/jmir.6296

Daniel M Walker, Timothy R Huerta + Show 2 more

Open Access

https://doi.org/10.2196/jmir.6296

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Abstract

BackgroundAs electronic health records (EHRs) become ubiquitous in the health care industry, privacy breaches are increasing and being made public. These breaches may make consumers wary of the technology, undermining its potential to improve care coordination and research.ObjectiveGiven the developing concerns around privacy of personal health information stored in digital format, it is important for providers to understand how views on privacy and security may be associated with patient disclosure of health information. This study aimed to understand how privacy concerns may be shifting patient behavior.MethodsUsing a pooled cross-section of data from the 2011 and 2014 cycles of the Health Information and National Trends Survey (HINTS), we tested whether privacy and security concerns, as well as quality perceptions, are associated with the likelihood of withholding personal health information from a provider. A fully interacted multivariate model was used to compare associations between the 2 years, and interaction terms were used to evaluate trends in the factors that are associated with withholding behavior.ResultsNo difference was found regarding the effect of privacy and security concerns on withholding behavior between 2011 and 2014. Similarly, whereas perceived high quality of care was found to reduce the likelihood of withholding information from a provider in both 2011 (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.56-0.94) and 2014 (OR 0.61, 95% CI 0.48-0.76), no difference was observed between years.ConclusionsThese findings suggest that consumers’ beliefs about EHR privacy and security, the relationship between technology use and quality, and intentions to share information with their health care provider have not changed. These findings are counter to the ongoing discussions about the implications of security failures in other domains. Our results suggest that providers could ameliorate privacy and security by focusing on the care quality benefits EHRs provide.

Highlights

Electronic health records (EHRs) are an omnipresent feature throughout the health care system, having been adopted by the majority of hospitals and physicians [1,2,3,4]
No difference was found regarding the effect of privacy and security concerns on withholding behavior between 2011 and 2014
Whereas perceived high quality of care was found to reduce the likelihood of withholding information from a provider in both 2011 and 2014, no difference was observed between years

Summary

Introduction

Electronic health records (EHRs) are an omnipresent feature throughout the health care system, having been adopted by the majority of hospitals and physicians [1,2,3,4]. HIT can serve as a tool to enable better patient-provider communication, for example through secure messaging, leading to more patient-centered care [8,9] Despite these potential benefits, recent high-profile, EHR security breaches reported in the media [10,11] make patients wary of this shift to the digital format [12,13]. Due to limitations of the specific iteration of the dataset used by both authors, the study by Campos-Castillo et al did not include privacy and security concern items, and the study by Agaku et al did not include quality perceptions While these 2 studies provide a foundation for understanding how patient concerns can manifest themselves in adverse behaviors, they examined different factors that taken together might result in different PHI withholding behaviors. These breaches may make consumers wary of the technology, undermining its potential to improve care coordination and research

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Conclusion