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

Introduction 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). Discussion 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.