Increased electronic information sharing by sexual health services: Confidentiality and consent

Abstract

New Zealand is moving towards an integrated health-care model with information accessible electronically regardless of location, linking existing health provider systems, regional clinical results repositories and a shared care record. However, such information sharing has been a major concern for patients attending sexual health services. In this study, we investigated patient attitudes towards a change in practice to support an integrated care model. Outcomes showed that confidentiality remains a significant concern, and routine sharing of patient information may create barriers to attendance for some, leading to a potential increase in untreated infections. We conclude that sexual health services may be able to change their information management practices to an opt-out consent system and routinely share health information with other health providers, but further public discussion to ensure informed consent is needed before this can happen. Regardless of national policy, it is still necessary to keep clinic visit details confidential for some patients attending sexual health services.

A cross-sectional survey exploring attitudes towards provincial electronic health record implementation among clients attending the Provincial Sexually Transmitted Infections Clinic in British Columbia

“…Our findings concur with the findings of a recent study in New Zealand on the attitudes towards electronic record sharing in sexual health services where 31% said that they would prefer no other health professional to know about their attendance at clinic, and 47% of self-referred patients stated that confidentiality concerns were the main reason for attending 23. In their study, 31% said that they would stop attending the clinic if discharge letters were sent to their general practitioner and 21% said they would stop using the clinic if their personal health number was used on laboratory tests 23…”

“…New Zealand currently uses an opt-in strategy for EHR. In planning for an opt-out model, Hunter, Haining and Whiddett conducted a survey where 39% of patients expressed that they wanted more information, prior discussion or consent before they felt comfortable with their sexual health service records being integrated with EHR 23. This has been echoed in another study where clients’ acceptability of sharing electronic health information was dependent on building trust in providers and institutions prior to EHR implementation 28.…”

“…Similarly, the results from our study suggest that careful planning to address patient privacy concerns and evaluation of the impacts should be conducted during the implementation and use of EHR. Measures to increase patient knowledge about EHR integration may help normalise the idea of EHRs and improve acceptability; however, patient education strategies in the UK and Scotland had limited success and warrant further assessment of best practices 23 29 30…”