User acceptance of Electronic Health Records: the relationship between comfort levels and consent

Abstract

Background: This paper presents findings from a study of the relationship between a person’s level of comfort with a situation and their willingness to consent to it happening, in the context of sharing personal information using electronic health records (EHRs). Methods: 87 vignettes were defined which describe the sharing of personal health information with various people for various reasons. Different degrees of anonymity and levels of detail were also considered. A representative sample of the adult population of New Zealand was interviewed using Computer Aided Telephone Interviewing (CATI) technology. Respondents were presented with a random selection of vignettes and asked how comfortable they would be to share their information (on a scale of 1-10) and whether they would give consent (yes/no). Findings: 31,146 pairs of responses were obtained from 4209 respondents. The percentage of respondents who would consent to share at a particular level of comfort followed a modified logistic regression curve. The percentage consenting rises very steeply between the comfort levels of 3 (20% consent) and 6 (90% consent). No significant differences arose from respondent characteristics, nor from most parameters of the situation. The only significant difference was that at any particular comfort level, people were more likely to consent if the recipient is a hospital doctor or ambulance paramedic. Discussion: The results suggest that the best way to increase acceptance of innovations in healthservice delivery, such as using EHRs, is to focus on ways to increase the comfort level of people in the 3 to 6 range.