2010 public opinion research: a nation-wide study of attitudes towards electronic health records and...
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2010 Public Opinion Research: A Nation-Wide Study of Attitudes Towards Electronic Health Records and Health System Use of Patient Information
This study was commissioned by the Canadian Institute for Health Information (CIHI) and Canada Health Infoway.
March 2010
Background
• This nation-wide survey was conducted via telephone between February 25th and March 8th 2010
• 1,000 adult Canadian were selected on a random probability basis to be interviewed
• Results from this survey can be considered accurate within a margin of error of +/- 3.1%
• The survey was conducted to:– Obtain baseline measures of key attitudes towards EHR and HSU which can be
tracked, over time– Quantify opinion to these issues, observed in an earlier phase of qualitative
research
Top Problem Facing The Health Care System
Q: “What would you say is the most important issue facing the health care system today?
Reported State of Personal Health Care Records
High Categories for Difficult to Access
Post-Grad (34%)
Quebec (30%)
$100k+ (29%)
25-34 Yrs (28%)
Q: How would you describe the state of your health records…
22%
Impact of Health Records on the Kind of Care Received
High Categories for Negative Responses
Post-Grad (20%)
$80k+ (20%)
Quebec (19%)
Females (17%)
Q: Would you say that the way your health care records are maintained has a … impact on the kind of care you receive?…
14%
Impact of Health Records on the Health Care System
High Categories for Big Problem
Post-Grad (40%)
Quebec (40%)
55 Yrs+ (39%)
$80-$100k (38%)
Q: Would you say that the way personal health records are maintained is…for the health care system
31%
Relation Between Perceived State of Health Care Records and Quality of Care and System Impacts
All in one place and very easy to
access
Mostly in one place and fairly easy to
access
In a number of places and fairly
difficult to access
All over then place and very difficult to
access
Impact on Personal care
Positive 72% 62% 17% 18%
None 23% 27% 36% 26%
Negative 1% 7% 40% 52%
Impact on System
Very big/Big problem 20% 26% 51% 63%
Small/No Problem 71% 65% 44% 35%
Recognition that Canada has a Goal and a Plan to Convert All Personal Health Records from a Paper Format to an Electronic Format
Lower Recognition
18-34 Yrs (28%)
Alberta (31%)
B.C. (35%)
High Recognition
Post Grad (61%)
45-54 Yrs (56%)
Ontario. (55%)
Quebec (54%)
Q: Do we have a goal and a plan to convert all personal health care records in Canada from a paper to an electronic format?
18%
Reaction to the Idea of Converting All Personal Health Records from a Paper Format to an Electronic Format
High Categories – Good idea
$60k+ (83%)
Families (83%)
Quebec (82%)
25-34 Yrs (80%)
Atlantic (80%)
Employed (80%)
Q: On balance, do you think converting personal health records from a paper to an electronic format is…
High Categories – Bad idea
Unemployed (33%)
Homemakers (27%)
18-24 Yrs (27%)
Alberta (27%)
Under $40k (26%)
Less than HS (26%)
Concerns About Electronic Health Care Records
Q: “Is there anything about having your health car records in an electronic format that would concern you?
High Categories – Concern
Unemployed (77%)
Alberta (73%)
35-44 Yrs (69%)
Ontario (66%)
Reported Use of Electronic Record in Principal Doctor’s Office
Low Categories – No
Quebec (61%)
$40k-$60k (50%)
Student (49%)
High Categories - Yes
Alberta (55%)
Homemaker (49%)
Ontario (44%)
55+ (43%)
Q. Does your principal doctor or care provider use an electronic record in their office?
Impact of Principal Care Giver Having EMR on Patient’s View that EHRs are a Good Idea or a Bad Idea
Have EMR Don’t have EMR
EHR’s are…
Good idea 78% 73%
Bad idea 17% 22%
Knowledge of Current Use of Personal Health Information for Other than Direct Patient Use
High Categories - Yes
Quebec (26%)
Homemaker (22%)
Q: As far as you know, is personal health information used for any purpose other than by your health provider in giving care to an individual patient?
Can Electronic Records be Used in Different or More Ways than a Paper Record ?
High Categories - Yes
$100k (81%)
Post-Grad (79%)
25-34 Yrs (76%)
Unemployed (76%)
Student (75%)
Q: Do you think that personal health information could be used in different or more ways if it was stored as an electronic record, compared to a paper record?
Reported Recall of the Term “Health System” or “Secondary Use” of Patient Information
High Categories - Yes
Quebec (47%)
55-64 Yrs (42%)
$80k + (41%)
Q: Have you ever heard of Health System or Secondary Use of Patient Health Information?
Perceived Impacts of HSU of information on Patient Care and the Operation and Quality of Health Care in Canada
Q: Does Health System or Secondary Use of patient health information strike you as something that is going to have a … impact on the operation and quality of health care/the kind of care you might receive?
Perceived Impact of Various HSU of Data on Health Care in Canada…Front line Health Care
Q: What sort of impact would the following use of information for HSUs have on health care in Canada…Improving front line health care
Perceived Impact of Various HSU of Data on Health Care in Canada… Efficiency and Effectiveness of Health Care Delivery
Q: What sort of impact would the following use of information for HSUs have on health care in Canada… Improving efficiency and effectiveness of health care delivery
Perceived Impact of Various HSU of Data on Health Care in Canada… Tracking Public Health
Q: What sort of impact would the following use of information for HSUs have on health care in Canada… Tracking the health of the general population
Perceived Impact of Various HSU of Data on Health Care in Canada… Medical and Health Research
Q: What sort of impact would the following use of information for HSUs have on health care in Canada… Strengthening Medical and Health Research
Perceived Impact of Various HSU of Data on Health Care in Canada… Percent of Very Positive Reponses
22%
24%
27%
32%
0% 5% 10% 15% 20% 25% 30% 35%
Research
Efficiencies
Tracking public health
Front line care
Q: What sort of impact would the following use of information for HSUs have on health care in Canada
Reported Levels of Concern About Individual Information Being Used for HSU Purposes
Q: How concerned would you be about your health information being used for these types of HSUs
High Concern
Unemployed (62%)
Females (55%)
25-34 Yrs (55%)
Low Concern
100k+ (32%)
18-24 (35%)
Man/Sask (38%)
Reported Levels of Concern if Information was De-identified
Q: If your health information was de-identified, how concerned would you be about it being used for HS purposes?
High Concern
Under $40k (41%)
BC (40%)
High School (40%)
Low Concern
$80k (21%)
Post Grad (23%)
25-44 Yrs (25%)
Comfort with Sharing De-identified Information with Various Organizations – Provincial Department of Health
Q: How would you feel about sharing your de-identified information with the following organization…
Comfort with Sharing De-identified Information with Various Organizations – Other Health Care Organizations
Q: How would you feel about sharing your de-identified information with the following organization…
Comfort with Sharing De-identified Information with Various Organizations – Research Organizations
Q: How would you feel about sharing your de-identified information with the following organization…
Comfort with Sharing De-identified Information with Various Organizations – Statistical Organizations
Q: How would you feel about sharing your de-identified information with the following organization…
Comfort with Sharing De-identified Information with Various Organizations – Private Organizations
Q: How would you feel about sharing your de-identified information with the following organization…
Comfort with Sharing De-identified Information with Various Organizations – ( Net Scores -- Comfortable Minus Uncomfortable)
Q: How would you feel about sharing your de-identified information with the following organization…
Control of Decision to Share Information – Perceived and Preferred
Q: Does Health System or Secondary Use of patient health information strike you as something that is going to have a … impact on the operation and quality of health care/the kind of care you might receive?
Comfort with Use of Identified Information
Q: How comfortable would you feel if your information was identified and contained your name and address?
High Concern
Female (62%)
Post-Grad (60%)
Retired (59%)
$60k-$80k (59%)
B.C. (58%)
Comparison of Comfort/Concern about the General Concept of HSU vs De-Identified vs Identified Uses
Level of Demand for Consent in Cases Where Identified Information was Used
Q: How would you feel about a requirement that your personal approval or consent would have to be given before de-identified information was used?
High Consent Required
Post-Grad (81%)
$80k-$100k (79%)
Female (74%)
55-64 Yrs (73%)
Reported Likelihood of Granting or Withholding Consent, if Required for Identified Use
Q: If your approval or consent was required… Do you think you would or would not give your approval or consent?
Likelihood of Granting Consent Based on Likelihood of Insisting on Consent
Insist on Consent (67%)
Prefer Consent (22%)
Wouldn’t care (9%)
Would grant (69%)
64% 77% 81%
Would not grant (21%)
22% 15% 18%
Don’t Know (11%)
13% 7% 1%
Reaction to the idea of an Independent Oversight Body to Approve Identified Use
Insist on Consent (67%)
Prefer Consent (22%)
Wouldn’t care (9%)
Oversight adds comfort (65%)
67% 40% 39%
Makes no difference (33%)
31% 55% 57%
Q: Would you be more comfortable if you knew that use of identified information would be reviewed and approved?
The Size of Hard Resistance to HSU
Expectation that Personal Doctor would Notify Patient when Information was used for HS Purposes
Q: Would you expect your doctor or care giver to notify you about when and how your information was being used?
Privacy Vs HSU – Which is Most Important?
High Privacy
Living alone (48%)
Female (45%)
Under $40k (45%)
High School (45%)
45-64 Yrs (45%)
High HSU
$80k+ (63%)
35-44 Yrs (61%)
18-24 Yrs (59%)
Q: What is more important to you: Protecting the privacy of your health information or being able to use it for HSU?