Though the potential for electronic health records (EHRs) to improve the quality of health care is generally understood, we understand less about how these new forms of health information technology (HIT) shape privacy perceptions and how they affect the exchange of information between doctors and their patients. Youth, in particular, have a variety of privacy concerns when seeking health care and when confiding in health care providers. In order to receive effective treatment, youth must be willing to share personal health information with their providers. However, concerns about privacy, such as who has access to and use of electronic data, may lead youth to withhold information, thus compromising a provider's ability to adequately and effectively deliver health care. The added uncertainty of privacy protections offered through the use of EHRs raises questions about how pediatrician/patient interactions will be affected. Chiefly, will the use of EHRs affect privacy perceptions among youth populations and, thus, the extent to which they communicate health information to their providers? Secondly, will these privacy concerns affect the way pediatricians use HIT and record information into EHRs? The goal of this project is to explore the role that EHR use plays in shaping privacy perceptions and interactions among youth and pediatrician providers. I address research area two of the current FOA (PAR-08-268) by evaluating the role of HIT to support patient-centered care and discuss the implications of findings for the growing use of EHRs and their potential for facilitating information sharing in health care. I plan to conduct qualitative, in-depth interviews with youth pediatric patients between the ages of 15 and 18 and pediatricians (out-patient service general pediatric providers and pediatric specialists) within one academic medical center in the northeastern United States (Dartmouth Hitchcock Medical Center, New Hampshire). Interviews will be digitally voice recorded and transcribed, then coded and analyzed using a qualitative analysis software program. The coding and analysis of interview data will identify a broad spectrum of privacy expectations and practices among both patient and pediatrician providers to understand how these privacy expectations guide information exchanges, clinical interactions, and EHR use.
I seek to explore how perceptions of electronic health records and privacy shape the flow of information between pediatricians and their patients and the subsequent consequences to health care delivery posed by the use of health information technology facilitating information exchanges.