Electronic health records: Good, bad or both?

Publication Date

Timothy Stablein, assistant professor of sociology

(With Joseph Lorenzo Hall, Center for Democracy and Technology; Chauna Pervis, American University College of Law; Denise L. Anthony, Dartmouth College)

Our entire lives can be charted on computers – social lives on Facebook, careers on LinkedIn, shopping habits on Amazon. Even our health history is just a click away these days.

Timothy P. Stablein

And this last one has a sharp double-edge to it, particularly for individuals who might face stigmatization, as Timothy Stablein and his colleagues discovered when they interviewed 30 sexual-minority men.

“We explored how they perceived the role of electronic health records in the clinical encounter in general and for disclosure in particular,” he said. “We found that the use of electronic health records had the potential to both improve and compromise interactions with health care providers.”

Some men worried that e-records might narrowly label them as a “type” of patient with certain “types” of health needs, potentially limiting their care or subjecting them to unnecessary testing. These individuals also expressed concern that being labeled would compromise interactions with providers where they might not have chosen to share their sexuality.

“It wasn’t necessarily that the record contained this information,” Stablein said, “but rather that its widespread availability meant giving up the option to choose to selectively disclose it.”

This very thing, however, was seen as a benefit by other men.

“They felt widespread access had the ability to make care more efficient across a variety of health settings, giving each doctor access to all information,” Stablein said. “In addition, given that disclosing stigmatizing information can be stressful and difficult, the relief of not having to do this with each new provider was seen as a real benefit.”

The privacy of e-records was similarly both positive and negative.

Some men believed electronic records were not as secure as paper, while others felt e-records were more secure and provided greater confidentiality.

Whether electronic health records improve care remains to be seen, but one thing is certain.

“This has potential implications for all who receive health care in the digital age, not only those who experience stigma, but anyone concerned about the privacy and use of their health information,” Stablein said.


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