EHRs have become a ubiquitous fixture in doctor’s offices and hospitals nationwide, with adoption levels reaching nearly 90 percent. With that surge comes an increase in EHR security events during which patient data may be put at risk for breach.
In a recent study published in the Journal of Medical Internet Research, a team of investigators sought to determine how this relationship affects patients and their willingness to contribute their data to the digital tools.
“Recent high-profile, EHR security breaches reported in the media make patients wary of this shift to the digital format,” the research team reported.
“Patients are concerned about the privacy of their information and its security as it is stored and transferred across the health care system. These concerns can manifest themselves in a range of behaviors that can undermine the potential of the technology to facilitate improved care.”
Notably, patients may be less willing to share their health information with their patients out of fear of an EHR security event. This may negatively impact care as providers attempt to leverage the EHR to improve care quality, coordination, and overall patient satisfaction.
However, according to the researchers, patient perceptions of quality care may mediate this issue. When patients perceive their providers as delivering high-quality healthcare, they may be more trusting or believe that the likelihood of an EHR security event is lower.
The researchers sought to answer two questions. First, they sought to determine whether EHR security fears and perceptions of quality care affected patient willingness to share their health data. Second, the researchers sought to see if patient willingness changed over time.
Using data from the Health Information National Trends Survey from 2011 through 2014, the researchers assessed the effect of EHR security and quality care perceptions on patient EHR use.
Overall, the same approximate number of patients (14.79 percent and 14.92 percent, respectively) withheld information from their providers’ EHRs between 2011 and 2014. The researchers also found that concerns about EHR security events did not affect patient willingness to share health information. This finding did not change between 2011 and 2014.
Additionally, the researchers found that patient perceptions of quality care modestly decreased the likelihood that patients would withhold health data. This finding did not change between 2011 and 2014, the investigators reported.
Ultimately, this shows that quality healthcare may be a viable was to ease patient worry regarding EHR security.
“Overall, our analysis suggests that in spite of the existence of security and privacy concerns, focusing resources on the delivery of high-quality care may be an effective strategy to foster patient trust,” the researchers said. “Patients may perceive quality as an indicator of a provider’s carefulness with their medical information. Quality may also help to build the patient-provider relationship.”
Patients may also be weighing the benefits of physician EHR use with data security risks, the research team offered. Patient may reason that receiving high-quality, coordinated care may be worth risking their health data via the EHR.
In contrast, a recent Black Book survey suggested that EHR data security may affect patient engagement and data sharing habits. The survey found that 57 percent of patients are skeptical of health IT use, and that skepticism is primarily driven by EHR security events.
Doug Brown, Black Book’s managing partner, echoed the researchers’ concerns about the effect this trend may have on care quality.
"Incomplete medical histories and undisclosed conditions, treatment or medications raises obvious concerns on the reliability and usefulness of patient health data in application of risk based analytics, care plans, modeling, payment reforms, and population health programming," said Brown.
Ultimately, these fears warrant a better look from EHR security experts, Brown suggests.
As EHRs continue to play a significant role in quality improvement, providers will continue to leverage them. In order to make physician EHR use truly effective, patients need to trust these technologies.