Patients approve of HIE, but want strong security measures

Patients are generally okay with the electronic storage and transmission of their health information as long as privacy and security safeguards are in place, according to research published in the September/October issue of Annals of Family Medicine.

Researchers, led by Rina V. Dhopeshwarkar, MPH, of Weill Cornell Medical College in New York City,  and colleagues conducted a survey of 170 individuals from eight N.Y. counties to learn how patients felt about health information exchange (HIE). They asked participants 42 questions to determine demographic characteristics, self-reported health, healthcare utilization, internet use and perceptions of EHRs and electronic HIE.

The researchers also asked about their comfort level with three different HIE models: patient health information (PHI) stored on a small device that patients could manually transport; PHI stored at locations where patients received care that could be transported via secure connection; and password-protected PHI stored in a central database that could be transported via secure connection. One survey question asked patients to rate the importance of security and privacy measures listed for them.

Participants were most comfortable with storing PHI on portable devices, but a majority was comfortable with each of the three HIE models described: 83 percent said they were comfortable having PHI stored on portable devices, 79 percent were comfortable with PHI being stored at provider locations and 68 percent were comfortable with PHI being stored in a central database.

Participants were overwhelmingly more likely to trust their providers with the storage and maintenance of PHI than any other group listed, with 51 percent choosing their providers over health plans, hospitals or the government.

A wide majority of participants gave each privacy and security measure listed a high importance rating. These included safeguards against unauthorized viewing (86 percent), ability to see who has viewed your record (86 percent), ability to stop information from being stored electronically (84 percent), ability to stop all viewing of the record (83 percent) and ability to choose what parts of the record are shared electronically (78 percent).

Participants were generally comfortable with their primary care providers viewing their information. Sixty-four (64) percent were comfortable with their PCPs viewing information with permission and 35 percent without. They were also comfortable with other providers, family members and their information.

More than 75 percent of respondents said they would be comfortable having each of these groups view their information, whether with or without permission. Nearly 70 percent said they would never allow government officials to view their information and 61 percent said they would never allow their employers to see their information.

“Consumer buy-in is necessary for the success of national HIE initiatives,” Dhopeshwarkar et al concluded. “To address consumers’ concerns about the exchange of their health information, their preferences should be incorporated into future iterations of HIE standards and consent policies.”