Racial differences in patient consent policy preferences for electronic health information exchange.

Autor:	Turvey CL; labelVirtual Specialty Care QUERI Program: Implementing and Evaluating Technology Facilitated Clinical Interventions to Improve Access to High Quality Specialty Care for Rural Veterans, Seattle, Washington & Iowa City, Iowa, USA.; VA Office of Rural Health, Rural Health Resource Center, Iowa City, Iowa, USA.; Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation Center, Iowa City, Iowa, USA.; Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA., Klein DM; VA Office of Rural Health, Rural Health Resource Center, Iowa City, Iowa, USA.; Iowa City VA Health Care System, Comprehensive Access and Delivery Research and Evaluation Center, Iowa City, Iowa, USA.; Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.; J P Systems, Clifton, Virginia, USA., Nazi KM; Independent Information Technology Consultant, Coxsackie, New York, USA., Haidary ST; Veterans and Consumers Health Informatics Office, Office of Connected Care, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC, USA., Bouhaddou O; US Department of Veterans Affairs, Veterans Health Information Exchange Program, Washington, DC.; innoVet Health, San Diego, California, USA., Hsing N; US Department of Veterans Affairs, Veterans Health Information Exchange Program, Washington, DC., Donahue M; US Department of Veterans Affairs, Veterans Health Information Exchange Program, Washington, DC.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Informatics Association : JAMIA [J Am Med Inform Assoc] 2020 May 01; Vol. 27 (5), pp. 717-725.
DOI:	10.1093/jamia/ocaa012
Abstrakt:	Objective: This study aimed to explore the association between demographic variables, such as race and gender, and patient consent policy preferences for health information exchange as well as self-report by VHA enrollees of information continuity between Veterans Health Administration (VHA) and community non-VHA heath care providers. Materials and Methods: Data were collected between March 25, 2016 and August 22, 2016 in an online survey of 19 567 veterans. Three questions from the 2016 Commonwealth Fund International Health Policy Survey, which addressed care continuity, were included. The survey also included questions about consent policy preference regarding opt-out, opt-in, and "break the glass" consent policies. Results: VHA enrollees had comparable proportions of unnecessary laboratory testing and conflicting information from providers when compared with the United States sample in the Commonwealth Survey. However, they endorsed medical record information being unavailable between organizations more highly. Demographic variables were associated with gaps in care continuity as well as consent policy preferences, with 56.8% of Whites preferring an opt-out policy as compared with 40.3% of Blacks, 44.9% of Hispanic Latinos, 48.3% of Asian/Pacific Islanders, and 38.3% of Native Americans (P < .001). Discussion: Observed large differences by race and ethnicity in privacy preferences for electronic health information exchange should inform implementation of these programs to ensure cultural sensitivity. Veterans experienced care continuity comparable to a general United States sample, except for less effective exchange of health records between heath care organizations. VHA followed an opt-in consent policy at the time of this survey which may underlie this gap. (Published by Oxford University Press on behalf of the American Medical Informatics Association 2020. This work is written by US Government employees and is in the public domain in the US.)
Databáze:	MEDLINE
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