title: A cross-sectional survey exploring attitudes towards provincial electronic health record implementation among clients attending the Provincial Sexually Transmitted Infections Clinic in British Columbia.
abstract: BACKGROUND
  To support control of sexually transmitted infections (STI), British Columbia is exploring data sharing through a provincial electronic health record (EHR). Increased electronic data sharing among healthcare providers may be a barrier for clients of STI clinics where expectations of privacy and confidentiality are heightened.
  
  
  METHODS
  A survey to assess attitudes towards sharing of personal health information through a provincial EHR was conducted with a convenience sample of clients attending an STI clinic in Vancouver. Descriptive statistics and logistic regression were used to examine the association between the primary outcome variable, whether a client would be less likely to take the test for an STI or HIV if their clinic records were made part of a provincial EHR, and independent variables of interest.
  
  
  RESULTS
  A total of 1004 clients completed the survey, and 31% stated that they would be less likely to get tested for STI/HIV if their records were made part of a provincial EHR. Participants who were more likely to agree that they might avoid testing had the expectation that no other clinician would review their chart (adjusted OR (AOR)=3.55), or expected their records would not be shared beyond the clinic (AOR=2.81).
  
  
  CONCLUSIONS
  While most participants thought an EHR was acceptable, a large minority expressed that they might avoid testing if their records were made part of a provincial EHR. The introduction of a provincial EHR should be considered with caution in STI healthcare settings to ensure that screening, case detection and treatment are not negatively impacted.
authors.affiliation: Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Pedersen
authors.affiliation: Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Darlene
authors.initials: D
authors.lastname: Taylor
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Gilbert
authors.affiliation: Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Achen
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Lester
authors.affiliation: Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000379:methods*; D008875:Middle Aged; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D055815:Young Adult
keywords: ATTITUDES; HEALTH SERV RESEARCH; SERVICE DELIVERY; SEXUAL HEALTH