The role of health care experience and consumer information efficacy in shaping privacy and security perceptions of medical records: national consumer survey results.

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This is a review of Patel, Beckjord, Moser, Hughes, and Hesse’s 2015 article, titled " The Role of Health Care Experience and Consumer Information Efficacy in Shaping Privacy and Security Perceptions of Medical Records: National Consumer Survey Results". [1]

Background

The evolution of both technology and policy to address privacy and security needs is critical, as providers’ use of EHRs has grown rapidly since HITECH. As EHRs become the norm, a majority of patients’ medical records will become digitized, enabling providers to share health information electronically with other providers to better coordinate care.[1]

Using data from a nationally representative survey of adults conducted by the National Cancer Institute (NCI) in 2011-2012, the authors sought to answer the following questions:[1]

  • How confident are adults in the privacy and security of their medical records? What technology-related care experience and patient engagement–related factors are associated with consumer confidence in privacy and security?
  • What proportions of adults have withheld information from their provider due to privacy or security concerns? What technology-related care experience and information efficacy–related factors are associated with withholding information?
  • What are adults’ levels of concern regarding sending health medical information from one provider to another? Does this vary by whether it is sent by fax or electronically, and what differentiates adults who express concerns about these different modes of sharing electronic health information?

Methods

The data presented in the article is from the 2011-2012 administration of the NCI Health Information National Trends Survey (HINTS). HINTS is a nationally representative survey of the US non-institutionalized adult population (≥18 years) that tracks attitudes, knowledge, and behavior related to health and cancer communication and health outcomes, with an emphasis on the evolution of health information technology in health care. [2]

Information efficacy was assessed with the question “Overall, how confident are you that you could get advice or information about health or medical topics if you needed it?” (completely confident, very confident, somewhat/a little/not at all confident).[1]

Results

  • Overall, three-quarters of adults reported they were very or somewhat confident in the security of their medical records (75.45%, 2570/3461).
  • Three-quarters of adults also reported they were either very or somewhat confident in the privacy of their medical records (75.41%, 2586/3469).
  • A total of 12.33% (520/3904) of adults reported they had kept information from their health care provider because of concerns about the privacy and security of their medical information.
  • A quarter of adults were “very concerned” (24.89%, 892/3474) about unauthorized persons gaining access to faxed health information compared to 18.75% (724/3462) if the information was sent electronically.
  • Adults with higher levels of information efficacy had a significantly lower predicted probability of being concerned about both fax and electronic means of sending information between providers compared to adults with lower levels of information efficacy (49.61% vs 61.15%).

Conclusion

The transition from paper to electronic health records is not associated with negative perceptions regarding the privacy and security of individuals’ medical information. Individuals who believed their providers were using electronic modes of storing or sharing health information did not report lower levels of confidence or greater concerns. [1]

The findings in the article regarding the lack of association between perceptions of provider EHR adoption and privacy and security concerns are consistent with other national survey results, which also found a lack of association between whether an individuals’ doctor used an EHR and perceptions regarding the privacy of HIE.[1]

Comments

After reading this article it appears that the general population is content with the privacy and security of their medical records. It is interesting to note though, the main concern from individuals that responded to the survey was the sharing of information. It seems as if many are fine with their providers having the information, but when someone else obtains it, then there is a problem.

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Patel, V, Beckjord, E, Moser, RP, Hughes, P, Hesse, BW.(2015) The Role of Health Care Experience and Consumer Information Efficacy in Shaping Privacy and Security Perceptions of Medical Records: National Consumer Survey Results. JMIR Med Inform,3(2):e14. DOI: 10.2196/medinform.3238 .PMID: 25843686. Retrieved from http://medinform.jmir.org/2015/2/e14.
  2. ↑ Nelson DE, Kreps GL, Hesse BW, Croyle RT, Willis G, Arora NK, et al. The Health Information National Trends Survey (HINTS): development, design, and dissemination. J Health Commun 2004;9(5):443-60; discussion 81. [doi:10.1080/10810730490504233]
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