J Am Med Inform Assoc - The double-edged sword of electronic health records: implications for patient disclosure.

Tópicos

{ system(1050) medic(1026) inform(1018) }
{ ehr(2073) health(1662) electron(1139) }
{ studi(1119) effect(1106) posit(819) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
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{ survey(1388) particip(1329) question(1065) }
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{ estim(2440) model(1874) function(577) }
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{ take(945) account(800) differ(722) }
{ featur(1941) imag(1645) propos(1176) }
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{ imag(1057) registr(996) error(939) }
{ studi(2440) review(1878) systemat(933) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ howev(809) still(633) remain(590) }
{ studi(1410) differ(1259) use(1210) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
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{ patient(2315) diseas(1263) diabet(1191) }
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{ data(1714) softwar(1251) tool(1186) }
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{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ care(1570) inform(1187) nurs(1089) }
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{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ case(1353) use(1143) diagnosi(1136) }
{ data(3963) clinic(1234) research(1004) }
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{ spatial(1525) area(1432) region(1030) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ can(981) present(881) function(850) }
{ health(1844) social(1437) communiti(874) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ implement(1333) system(1263) develop(1122) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

JECTIVE: Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients' global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure.MATERIALS AND METHODS: A nationally representative sample from the 2012 Health Information National Trends Survey was analyzed using bivariate and multivariable logit regressions to examine whether global ratings of care suppress the relationship between EHR provider-use and patient non-disclosure.RESULTS: 13% of respondents reported having ever withheld information from a provider because of privacy/security concerns. Bivariate analysis showed that withholding information was unrelated to whether respondents' providers used an EHR. Multivariable analysis showed that accounting for respondents' global ratings of care revealed a positive relationship between having a provider who uses an EHR and withholding information.DISCUSSION: After accounting for global ratings of care, findings suggest that patients may non-disclose to providers to protect against the perceived EHR privacy and security risks. Despite evidence that EHRs inhibit patient disclosure, their advantages for promoting quality of care may outweigh the drawbacks.CONCLUSIONS: Clinicians should leverage the EHR's value in quality of care and discuss patients' privacy concerns during clinic visits, while policy makers should consider how to address the real and perceived privacy and security risks of EHRs.

Resumo Limpo

jectiv electron health record ehr system link improv qualiti care yet also privaci secur risk result research studi mix whether patient withhold person inform provid protect perceiv ehr privaci secur risk studi seek reconcil mix find focus whether account patient global rate care reveal relationship ehr providerus patient nondisclosuremateri method nation repres sampl health inform nation trend survey analyz use bivari multivari logit regress examin whether global rate care suppress relationship ehr providerus patient nondisclosureresult respond report ever withheld inform provid privacysecur concern bivari analysi show withhold inform unrel whether respond provid use ehr multivari analysi show account respond global rate care reveal posit relationship provid use ehr withhold informationdiscuss account global rate care find suggest patient may nondisclos provid protect perceiv ehr privaci secur risk despit evid ehr inhibit patient disclosur advantag promot qualiti care may outweigh drawbacksconclus clinician leverag ehr valu qualiti care discuss patient privaci concern clinic visit polici maker consid address real perceiv privaci secur risk ehr

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