View source for The double-edged sword of electronic health records: implications for patient disclosure

This is a review on Campos-Castiollo, C., & Anthony, D. L. (2014) article, The double-edged sword of electronic health records: implications for patient disclosure<ref name="Patient Disclosure"> Campos-Castiollo, C., & Anthony, D. L. (2014). The double-edged sword of electronic health records: implications for patient disclosure Journal of the American Medical Informatics Association, 1-7. doi: http://dx.doi.org/10.1136/amiajnl-2014-002804 </ref>.


=Background and Objective=
This article describes the issues related to [[EMR|electronic medical records (EMR)]], and patient perceptions of EMR's [[Privacy|privacy]] and security risks. Previous studies have shown mixed patient reactions to EMR, specifically, that patients concerned about [[Security|security]] are more likely to withhold information from physicians. The study’s aim was to figure out whether or not other factors, called suppressors, could account for the lack of correlation between [[electronic health record]] and patient [http://www.merriam-webster.com/dictionary/disclosure disclosure]. Application of [[data security]] and statistical disclosure techniques allows tradeoffs between data [[Usability|usability]] and [[Data security|data security]], giving researchers access to relevant data while at the same time minimizing the potential damage of a breach in data security. This was mentioned in "[[Patient Confidentiality in the Research Use of Clinical Medical Databases]]".

= Methods=
The study used two cycles of 2012 [https://www.healthdata.gov/data/dataset/health-information-national-trends-survey-hints  Health Information National Trends Survey] that asks patients how they would rate the quality of their care and whether or not they thought doctors should use electronic medical records. It also attempted to account for other suppressors including race, ethnicity, and socio-economic factors.

=Results=
The results showed that there is no suppression factor based on the perception of quality of care. There is no statistically significant suppression relationship between quality of care and patient’s withholding information. There was a slight suppression relationship between immigrant status and withholding information. 

The findings showed that patients actually withhold information from their providers very rarely. 13% of respondents have ever withheld information from provider because of privacy/security concerns. This is very important information because it suggests that providers are able to trust the information that patients give them and use it accordingly. However, one of the significant limitations of the study is the self-reporting of patients. Further, it is unclear whether or not quality of care is actually a relevant factor in determining if there is suppression. The study defines suppression as a factor that negatively influences one possibility and also increases the probability of another factor.

=Discussion and Comments=
The results of this study have extremely important implications for policies regarding the security of medical records. The presence of [[EMRs]] has little, if any, impact on whether or not people disclose their medical information to physicians. However, it is much easier to have breaches in security with electronic medical records. This means that physicians who have electronic medical records must take particular care to maintain their security. Patients are not fully aware of the risks of having their medical records electronically available. Thus it is the duty of those responsible for the security of medical records to make sure that the records are stored appropriately.

= References =
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[[Category: Reviews]]
[[Category: EHR]]
[[Category: Technologies]]