2012 public opinion research: canadian views on electronic health records this study was...

2012 Public Opinion Research: Canadian Views on Electronic Health RecordsThis study was commissioned by the Canadian Institute for Health Information (CIHI) and Canada Health Infoway.

March 2012

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Summary of Objectives• A baseline survey was conducted in 2010 to understand Canadians’ views on

a number of areas:– Situating electronic health records in the health care system;– Understanding the current state of Canadians’ health records;– Gauging awareness and impressions of electronic record transition; and– Determining awareness and impressions of Health System Usage of records.

• The 2012 survey explored the same areas to identify any changes in impressions from 2010.

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Summary of Methodology• A total of 1,010 telephone surveys were completed among Canadian adults,

(excluding the territories) 18 years of age and over– A random sample of Canadians was selected

• All households with a landline had an equal opportunity in participating in the study• The study was not designed to re-contact previous participants. Rather, a “fresh”

sample was pulled• Interviews were conducted between January 31 and February 10, 2012 and

averaged 13 minutes in length• Results from this survey can be considered accurate within a margin of error

of +/-3.1%, 19 times out of 20– Larger for sub-samples

• Data results are weighted to reflect the population– Base sizes (n) indicated below the data are unweighted numbers

• Don’t know responses are reported if 5% or greater

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Summary of Methodology (2)• The table below highlights the completions by region.

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Region Sample Size (Unweighted)

Atlantic Canada 101

Quebec 251

Ontario 329

Manitoba/Saskatchewan 103

Alberta 100

British Columbia 126

Total 1,010

Key Findings

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Key Findings from the ResearchOverall, the data show positive movement in a number of key areas:

• There has been an increase in receptivity to the idea of converting records from paper to electronic (up 11 points to 85% very good or good idea).

• Moreover, the proportion of Canadians who express some concern about the idea of electronic records has decreased.

• More Canadians in 2012 believe that their physician is using electronic records as compared to 2010 (50% vs. 38%).

• The data suggests that Canadians’ understanding of an electronic health record as a tool that goes beyond record keeping has increased. Additionally, there is a sense that electronic records would have some impact on patient care and the health care system.

• While there is comfort with health system usage of health information, there are two key considerations:– The data indicates that a majority of Canadians would insist on disclosure and consent when their

information would be used for this purpose.– The information would NOT be shared with private organizations such as insurance or pharmaceutical

companies

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Situating Electronic Health Records

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Key Findings: Situating Electronic Health Records (EHRs)• Initially, the survey suggests that EHRs are not a top-of-mind issue among Canadians

for the health care system.– Only 1 person in the full sample named electronic records as the top issue

• Instead, Canadians identify a number issues facing the Canadian health care system relating predominantly to availability/access of resources (25%) or speed of care (22%).

© Harris/Decima

Don't know

Other

Health Records/Electronic Health Records

Availability of/Access to equipment

Costs

Wait times

Availability of/Access to Doctors/Nurses

0% 20% 40% 60%

9%

33%

1%

3%

10%

18%

26%

8%

32%

2%

10%

22%

25%

2012 2010

<1%

Resources and access continue to dominate the health care agenda

Base: All respondents (n=1,010)

Q1. Overall, what would you say is the most important issue facing the Canadian Health Care system today – in other words, the one that concerns you most?

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Current State of Medical Records

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Key Findings: Current State of Medical Records• Similar to the findings in 2010, a majority have most or all of their medical records in

one place and are at least fairly easy to access. – 36% say their records are all in one place– 32% believe they are mostly in one place and fairly easy to access– Close to one in four say they are in a number of different places or all over the place

• Meanwhile, a majority of Canadians see a relationship between where their records are stored and the type of care they receive.– A perceived positive impact (59%) outstrips a perceived negative impact (14%)

• Perhaps not surprising, those whose records are all over consider it having a negative impact on the care they receive

• Canadians are not quite convinced that the way in which their records are stored is a big problem for the health care system at large– 7% very big problem; 28% big problem

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Two in three believe their records are fairly easy to access; mostly in one place

Q2. What about the state, condition and location of your personal health care records? As far as you know are they…

2010

2012

0% 20% 40% 60% 80% 100%

38%

36%

32%

32%

12%

11%

10%

12%

8%

8%

All in one place and very easy to access Mostly in one place and fairly easy to access

In a number of different places and fairly difficult to access All over the place and very difficult to access

Don't know


© Harris/Decima

A small majority believe how their records are maintained has a positive impact on the care they receiveQ3. Would you say the way your health care records are maintained has a very positive impact, a positive impact, no impact, a negative

impact, or a very negative impact on the kind of care you receive?

2010

2012

0% 20% 40% 60% 80% 100%

10%

10%

44%

48%

27%

21%

12%

12%

2%

3%

5%

6%

Very positive Positive No impact Negative Very negative Don't know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

2%

4%

12%

15%

8%

12%

12%

8%

10%

17%

25%

58%

60%

47%

52%

49%

47%

48%

21%

34%

20%

16%

23%

20%

19%

23%

21%

37%

31%

5%

3%

14%

9%

11%

12%

12%

17%

3%

4%

2%

3%

3%

3%

Perceptions of the impact of record storage on the type of care received increases with age; views vary by storage of medical records

Q3. Would you say the way your health care records are maintained has a very positive impact, a positive impact, no impact, a negative impact, or a very negative impact on the kind of care you receive?

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

20%12%9%9%7%

16%10%11%8%8%8%

10%

57%46%

48%45%

44%63%

41%47%

52%51%

44%44%

48%

8%19%24%

24%27%

29%

19%18%

20%20%

31%24%

21%

7%13%

13%13%

10%5%

11%17%

9%12%

10%11%

12%

1%2%

2%3%

5%3%

3%4%1%3%2%

5%

3%

Very positive Positive No impact Negative Very negative


© Harris/Decima

Less convinced that the maintenance of records is a big problem for the health care system

Q4. And would you say that the way personal health care records are maintained is a very big problem, a big problem, a small problem or no problem whatsoever for the Canadian health care system?

2010

2012

0% 20% 40% 60% 80% 100%

6%

7%

25%

28%

35%

31%

24%

23%

10%

11%

Very big problem Big problem Small problem No problem Don't Know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

21%

11%

4%

2%

7%

6%

7%

7%

7%

47%

48%

24%

22%

32%

26%

29%

27%

28%

24%

31%

39%

29%

30%

33%

32%

30%

31%

4%

7%

23%

35%

22%

25%

21%

25%

23%

3%

3%

9%

12%

9%

10%

11%

11%

11%

Likelihood of recognizing problem is related to storage of recordsQ4. And would you say that the way personal health care records are maintained is a very big problem, a big problem, a small problem or

no problem whatsoever for the Canadian health care system?

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

4%9%

6%5%9%

2%

4%11%

6%6%

3%7%

7%

30%32%

33%26%22%

18%

31%34%

26%28%

27%23%

28%

26%30%

26%34%

39%41%

32%32%

28%34%

31%36%

31%

31%18%

25%22%

17%35%

21%16%

29%18%

25%22%

23%

10%12%10%

13%13%

3%

12%7%

11%14%14%12%

11%

Very big problem Big problem Small problem No problem Don't Know


© Harris/Decima

Those with easy access more convinced of the positive benefits


All in one place and very easy to access

Mostly in one place and fairly easy to access

In a number of places and fairly difficult to access

All over the place and very difficult to access

Impact on Personal care 2012 2010 2012 2010 2012 2010 2012 2010

Positive 76% 72% 70% 62% 29% 17% 20% 18%

None 16% 23% 20% 27% 34% 36% 21% 26%

Negative 3% 1% 6% 7% 34% 40% 54% 52%

Impact on System 2012 2010 2012 2010 2012 2010 2012 2010

Very big/Big problem 24% 20% 28% 26% 59% 51% 69% 62%

Small/No Problem 64% 71% 62% 65% 38% 44% 28% 35%

© Harris/Decima

Awareness and Impressions of Electronic Record Transition

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Key Findings: Awareness and Impressions of Transition• Just over half of Canadians believe that there is a goal to convert health records from

paper to electronic.

• While overall awareness has not changed, there has been a marked increase in the receptivity to converting personal health records from paper to electronic.– 46% say this a very good idea in 2012 in comparison to 29% in 2010

• Generally, those with records in more places are stronger proponents of this idea

• The primary concern with this idea continues to focus on privacy and identify theft. That said, fewer in 2012 say they have a concern in comparison to 2010.

• There has been an increase in perceptions that their physician is using an electronic record system in their office.– 50% say this is the case in 2012 vs. 38% in 2010– The data suggests that current use of an electronic record by their physician does not have

an impact on the perceived value of it• 86% with an EMR say it is a good idea while 84% of those without one feel this way

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Half think there is a goal of converting paper records to electronicQ5. As far as you know, do we have a goal and a plan to convert all personal health care records in Canada from a paper format into an

electronic format?

2010

2012

0% 20% 40% 60% 80% 100%

49%

52%

29%

25%

22%

22%

Yes No Don't Know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

46%

44%

58%

53%

50%

56%

54%

50%

52%

36%

35%

19%

24%

30%

22%

23%

28%

25%

18%

21%

23%

23%

20%

22%

23%

22%

22%

Younger Canadians are less aware of a national goal to convert records Q5. As far as you know, do we have a goal and a plan to convert all personal health care records in Canada from a paper format into an

electronic format?

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

48%53%56%55%

52%39%

49%54%56%

49%43%

48%

52%

24%23%

25%23%

26%40%

29%28%23%

27%27%

23%

25%

28%23%

19%21%22%21%

23%18%

21%25%

29%30%

22%

Yes No Don't Know


© Harris/Decima

Increase in receptivity to converting from paper to electronic recordsQ6. On balance, do you think that converting all personal health records from a paper format to an electronic format would be a very

good idea, a good idea, a poor idea or a very poor idea?

2010

2012

0% 20% 40% 60% 80% 100%

29%

46%

45%

39%

14%

8%

6%

4%

5%

3%

Very good idea Good idea Poor idea Very poor idea Don't Know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

54%

55%

48%

41%

43%

49%

44%

48%

46%

31%

33%

39%

42%

41%

37%

39%

38%

39%

10%

7%

7%

10%

9%

9%

10%

7%

8%

4%

2%

3%

5%

5%

2%

3%

4%

4%

Younger Canadians are the most receptive to the idea of an electronic format for health records

Q6. On balance, do you think that converting all personal health records from a paper format to an electronic format would be a very good idea, a good idea, a poor idea or a very poor idea?

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

37%41%

50%44%

53%46%

42%53%

48%41%

31%40%

46%

41%41%

39%40%

33%51%

43%35%

37%40%

46%45%

39%

11%9%

6%10%

9%4%

9%7%

7%5%17%

9%

8%

5%7%3%4%

2%3%

3%9%

4%4%

4%

Very good idea Good idea Poor idea Very poor idea


© Harris/Decima

Privacy continues to be the chief concern with electronic recordsQ7. Is there anything about having your health records in an electronic format that would concern you?

Don't know

No

Other

Selling/Commercial use of information

Information being misused/getting into wrong hands

Privacy/Identity Theft

0% 20% 40% 60% 80%

1%

52%

12%

3%

16%

31%

39%

25%

3%

20%

33%

2012 2010


© Harris/Decima

Reported Use of Electronic Records in Doctor’s office has risenQ8. Does your principal doctor or care provider use an electronic record in their office?

2010

2012

0% 20% 40% 60% 80% 100%

38%

50%

44%

36%

18%

14%

Yes No Don't Know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

48%

46%

52%

51%

100%

53%

47%

50%

37%

43%

39%

35%

100%

37%

35%

36%

16%

11%

8%

15%

10%

18%

14%

There is significant variance by region on reported use of electronic records

Q8. Does your principal doctor or care provider use an electronic record in their office?

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

55%49%

54%49%

46%43%

46%25%

55%48%

80%63%

50%

32%39%

37%41%

33%39%

44%58%

31%39%

10%25%

36%

13%13%

9%10%

22%17%

10%17%14%13%10%12%

14%

Yes No Don't Know


© Harris/Decima

Both those with and without electronic records feel that EHRs are a good idea


Have EMR Don’t have EMR

EHRs are… 2012 2010 2012 2010

Good idea 86% 78% 84% 73%

Bad idea 12% 17% 13% 22%

© Harris/Decima

Awareness of Health System Usage

© Harris/Decima

Key Findings: Awareness of Health System Usage• As far as most Canadians believe, personal health information is not used for any other

purpose other than by their health care provider.

• Meanwhile, three in four Canadians believe that personal health records that are electronic could be used in more ways as compared to paper records.

• There has been a notable decline in Canadians’ awareness of the term “Health System Use or Secondary Uses”: now 18% from 34% in 2010.

• Four areas of health system usages were tested:• Using this information to improve front-line health care• Using this information to better track the health of the general population• Using this information to improve the efficiency and effectiveness of health care delivery to the public• Using this information to strengthen medical and health research

• The data suggests that there has been in an increase in positive perceptions on health system usages of data on the overall healthcare system.– Increase most noted in the “very positive” impressions, as well as positive impressions overall

(top 2 box scores)

© Harris/Decima

Key Findings: Awareness of Health System Usage (2)• A strong majority believe that Health System Usage of data will have a major or minor

impact on both the healthcare system and patient care.

• There has been a decline in the proportion of Canadians who are concerned about their individual information being used for HSU.– 14% very concerned (down 6 from 20% in 2010) and 22% somewhat concerned (down 7

from 29% in 2010)

• The data suggests that de-identifying information alleviates some concern about personal use of data for HSU.

• An increasing number of Canadians are comfortable with sharing de-identified information with organizations where Canadians see value in sharing the data, such as health care organizations, research, and statistics.

• There is very little comfort with private organizations, such as drug and insurance companies.

© Harris/Decima

There continues to be limited awareness of using health information for purposes other than providing care

Q9. As far as you know, is personal health information used for any purpose other than by your health care providers in giving care to an individual patient?

2010

2012

0% 20% 40% 60% 80% 100%

17%

14%

69%

73%

13%

12%

Yes No Don't Know


© Harris/Decima

A majority believe that electronic records can be used in more ways than paper records

Q10. Do you think that personal health information could be used in different or more ways if it was stored as an electronic record, as compared to a paper record?

2010

2012

0% 20% 40% 60% 80% 100%

70%

76%

22%

17%

8%

7%

Yes No Don't Know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

78%

83%

76%

73%

72%

80%

72%

80%

76%

14%

11%

19%

19%

23%

14%

19%

15%

17%

8%

6%

5%

8%

6%

6%

9%

5%

7%

Quebecers are less aware of multiple uses of electronic recordsQ10. Do you think that personal health information could be used in different or more ways if it was stored as an electronic record, as

compared to a paper record?

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

68%75%76%79%

85%69%

84%62%

83%78%76%77%

76%

20%18%17%14%

12%31%

9%31%

12%15%

12%16%

17%

12%7%6%6%

3%

7%7%5%7%

12%7%

7%

Yes No Don't Know


© Harris/Decima

A decline in awareness the terms health system use or secondary usesQ11. Have you ever heard of Health System Use or Secondary Uses of patient health information?

2010

2012

0% 20% 40% 60% 80% 100%

34%

18%

64%

81%

Yes No


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

31%

18%

17%

16%

19%

17%

17%

19%

18%

69%

82%

82%

83%

80%

81%

82%

80%

81%

Younger Canadians least aware of Health System Use of informationQ11. Have you ever heard of Health System Use or Secondary Uses of patient health information?

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

16%20%20%18%17%

4%

18%17%17%16%20%18%

18%

81%79%79%81%81%

96%

81%81%81%83%77%82%

81%

Yes No


© Harris/Decima

A sense that HSU has an impact on health care and patient careQ12-13. Knowing a little more about Health System or Secondary Use of this information, does this strike you as something that can have

a major impact, a minor impact or no real impact on the operation and quality of health care in Canada/on the kind of care you might receive as a patient?


Health Care

2010

2012

0% 20% 40% 60% 80% 100%

55%

59%

29%

29%

11%

8%

6%

5%

Major impact Minor impact No real impact Don't know

Patient Care

2010

2012

0% 20% 40% 60% 80% 100%

42%

40%

36%

40%

17%

15%

5%

4%

© Harris/Decima

Overall increase in perceptions of benefits of HSU of information in a number of areas in health care

Q14-17. I’m going to read you a few more ways how health information from electronic records might be used for health system or secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or

very negative impact on the operation and quality of health care in Canada.

Using this information to strengthen medical and health research

Using this information to improve the efficiency and effectiveness of health

care delivery to the public

Using this information to better track the health of the general population

Using this information to improve front-line health care

0% 20% 40% 60% 80% 100%

31%

33%

35%

39%

50%

51%

52%

49%

13%

12%

9%

8%

2%

2%

2%

1%

Very positive Positive Neutral Negative Very negative


2012 2010

0% 20% 40% 60% 80% 100%

22%

24%

27%

32%

52%

54%

55%

49%

18%

14%

12%

12%

5%

5%

3%

3%

© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

46%

51%

39%

34%

40%

42%

42%

35%

39%

44%

40%

51%

53%

49%

47%

47%

51%

49%

9%

4%

8%

8%

8%

8%

7%

9%

8%

1%

3%

1%

1%

2%

1%

1%

1%

1%

0.01

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

37%37%

42%50%

37%18%

29%38%39%

45%39%43%

39%

52%47%

49%39%

51%76%

67%50%50%41%

41%46%

49%

6%12%

7%9%

8%6%

3%5%

9%10%

12%10%

8%

3%1%1%1%

2%1%

1%2%

1%

1%

1%

2%

Very positive Positive Neutral Negative Very Negative

Some variance in perceived impact on front-line health careQ14. I’m going to read you a few more ways how health information from electronic records might be used for Health system or

secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or very negative impact on the operation and quality of health care in Canada.

Using this information to improve front-line health care.


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

26%

38%

37%

31%

33%

36%

35%

30%

33%

54%

52%

47%

52%

49%

50%

49%

52%

51%

17%

9%

13%

11%

15%

11%

13%

12%

12%

2%

1%

1%

2%

1%

2%

1%

2%

2%

0.01

0.01

0.01

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

27%30%

37%36%37%

23%

32%33%35%35%

29%33%

33%

52%49%

49%54%

47%58%

53%51%49%

45%50%

55%

51%

13%13%

12%9%

12%19%

14%12%11%

15%13%

11%

12%

4%3%

1%1%

1%2%2%3%

1%

2%

3%

1%1%

1%

1%


Younger Canadians less likely to see very positive impacts on delivery of care to the public

Q15. I’m going to read you a few more ways how health information from electronic records might be used for Health system or secondary purposes and for each one have you tell me whether you think that it would have a very positive, positive, neutral, negative or

very negative impact on the operation and quality of health care in Canada.Using this information to improve the efficiency and effectiveness of health care delivery to the public.


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

35%

37%

37%

34%

33%

38%

35%

35%

35%

49%

59%

54%

51%

54%

51%

53%

52%

52%

10%

2%

7%

10%

10%

7%

7%

11%

9%

0.05

0.02

0.03

0.02

0.02

0.03

0.02

0.02

1%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

31%32%

41%39%

36%12%

34%37%35%39%

32%35%

35%

56%55%

49%47%52%

71%

62%49%53%44%

54%54%

52%

6%9%6%

13%10%

11%

2%8%10%

13%10%

8%

9%

3%3%2%

1%1%

6%

4%2%

1%2%3%

2%

0.01


Younger Canadians less positive that HSU of information would be able to better track the health of the population


very negative impact on the operation and quality of health care in Canada.Using this information to better track the health of the general population.


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

35%

38%

29%

29%

31%

32%

29%

34%

31%

49%

46%

53%

52%

50%

49%

51%

49%

50%

13%

11%

14%

10%

13%

13%

14%

12%

13%

2%

3%

2%

3%

3%

2%

3%

2%

2%

1%

1%

1%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

25%29%

36%34%

26%43%

27%36%

32%23%

29%26%

31%

55%51%

47%49%

53%39%

59%48%

50%56%47%

46%

50%

10%14%12%15%

17%8%

11%8%13%

15%17%

22%

13%

5%2%2%

1%10%

1%3%

2%

2%5%

2%

1%

1%

2%


Younger Canadians most likely to see a very positive impact on HSU of information for strengthening medical and health research


very negative impact on the operation and quality of health care in Canada.Using this information to strengthen medical and health research.


© Harris/Decima

Decline in personal concern of using health information for HSUQ18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health

information being used for these types of Health System Uses?

2010

2012

0% 20% 40% 60% 80% 100%

20%

14%

29%

22%

25%

33%

23%

30%

Very concerned Somewhat concerned Not very concerned Not concerned at all


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

17%

9%

12%

16%

15%

13%

16%

11%

14%

19%

23%

22%

21%

25%

22%

23%

22%

22%

34%

34%

35%

33%

33%

33%

31%

36%

33%

28%

31%

30%

29%

26%

30%

28%

31%

30%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

14%16%16%

10%11%9%

8%10%

16%17%

10%18%

14%

20%24%23%

22%21%23%

30%18%

23%20%

29%20%

22%

27%32%35%

30%40%

32%

27%42%

28%30%

35%38%

33%

36%27%26%

35%28%

36%

32%28%32%33%

26%24%

30%


Quebecers less concerned with secondary use of their informationQ18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health

information being used for these types of Health System Uses?


© Harris/Decima

De-identifying information further reduces concern of system usage of information

Q19. If your health information was de-identified, would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about it being used for Health system purposes?

2010

2012

0% 20% 40% 60% 80% 100%

15%

14%

19%

15%

26%

28%

39%

42%



© Harris/Decima

De-identifying information further reduces concern of system usage of information

Q18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health information being used for these types of Health System Uses?


De-identifying information

Initial concern with sharing information

0% 20% 40% 60% 80% 100%

14%

14%

15%

22%

28%

33%

42%

30%



© Harris/Decima

Relationship exists between initial concern of using information and concern if information is de-identified

Q18. Would you personally be very concerned, somewhat concerned, not very concerned or not concerned at all about your own health information being used for these types of Health System Uses?


Not concerned at all

Not very concerned

Somewhat concerned

Very concerned

0% 20% 40% 60% 80% 100%

4%

6%

20%

48%

9%

27%

48%

24%

34%

51%

16%

19%

52%

15%

15%

7%



© Harris/Decima

Little comfort with sharing de-identified information with private organizations

Q20-24. How would you feel about sharing your de-identified health information with the following organizations?

Private organizations such as drug companies or insurance companies

Your provincial government department of health

Statistical organizations such as Statistics Canada or the Canadian Institute for Health Information

Research organizations such as a University

Other health care organizations such as hospitals and regional health authorities

0% 20% 40% 60% 80% 100%

8%

36%

37%

39%

42%

21%

43%

43%

40%

43%

28%

12%

11%

12%

10%

42%

8%

8%

8%

5%

Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortableBase: All respondents (n=1,010)

2012 2010

0% 20% 40% 60% 80% 100%

7%

32%

34%

30%

33%

20%

40%

43%

42%

41%

28%

17%

14%

16%

17%

44%

10%

7%

11%

7%

© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

40%

40%

39%

34%

30%

41%

36%

36%

36%

38%

42%

44%

43%

45%

42%

43%

43%

43%

13%

15%

12%

12%

16%

9%

13%

12%

12%

10%

3%

5%

10%

7%

8%

8%

8%

8%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

32%29%33%

41%44%

41%

33%33%

40%36%

24%41%

36%

41%47%

46%40%

40%43%

45%52%37%43%

49%38%

43%

13%10%

15%16%9%12%

10%10%

13%12%

13%15%

12%

12%14%

6%4%

5%5%

11%4%

9%9%

11%6%

8%

Very comfortable Somewhat comfortable Somewhat uncomfortable Very uncomfortable

Albertans less comfortable with de-identified health information being shared with their provincial department of health

Q20. How would you feel about sharing your de-identified health information with the following organizations?Your provincial government department of health


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

41%

44%

46%

40%

36%

46%

41%

43%

42%

43%

44%

41%

42%

47%

40%

43%

44%

43%

10%

11%

9%

10%

11%

9%

10%

9%

10%

0.05

0.04

0.06

0.05

0.04

0.05

0.04

0.05

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

38%36%

43%43%47%50%

46%36%

44%38%

43%45%

42%

44%48%

44%41%

42%32%

41%49%

41%39%

40%45%

43%

11%10%

8%11%

6%18%

9%10%9%

17%11%

7%

10%

6%5%5%5%5%

3%3%6%5%6%2%

5%


Those with an EMR more comfortable with sharing information locallyQ21. How would you feel about sharing your de-identified health information with the following organizations?

Other health care organizations such as hospitals and regional health authorities.


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

42%

47%

42%

35%

35%

42%

38%

40%

39%

37%

38%

42%

39%

43%

38%

41%

39%

40%

13%

9%

9%

15%

14%

9%

12%

13%

12%

8%

5%

7%

9%

7%

10%

8%

8%

8%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

37%33%

41%42%

37%51%

30%41%

37%38%42%43%

39%

39%37%

40%39%

45%31%

42%46%

40%41%33%33%

40%

14%15%

14%10%9%13%

17%9%

12%11%

15%16%

12%

8%14%

5%9%9%5%

10%3%

11%11%10%6%

8%


Youth most comfortable with sharing information for researchQ22. How would you feel about sharing your de-identified health information with the following organizations?

Research organizations such as a University.


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

36%

45%

38%

35%

32%

39%

38%

36%

37%

49%

36%

44%

42%

45%

43%

42%

45%

43%

9%

14%

10%

13%

14%

10%

12%

11%

11%

5%

5%

7%

9%

8%

7%

8%

7%

8%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

33%31%

39%37%

42%40%

33%35%

40%35%33%

39%

37%

39%43%

47%43%

47%41%

45%48%42%

36%48%38%

43%

16%13%

9%11%

7%14%

12%11%

10%18%

8%14%

11%

11%11%

4%9%

5%5%

9%4%8%

11%9%7%

8%


Older Canadians slightly less comfortable with sharing de-identified information with statistical organizations

Q23. How would you feel about sharing your de-identified health information with the following organizations?Statistical organizations such as Statistics Canada or the Canadian Institute for Health Information.


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

8%

10%

10%

7%

8%

6%

7%

8%

8%

22%

21%

18%

25%

22%

22%

24%

19%

21%

25%

30%

31%

27%

28%

29%

30%

26%

28%

44%

39%

42%

40%

41%

43%

38%

47%

42%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

5%7%8%

5%10%13%

8%10%8%7%

3%5%

8%

16%16%

22%29%

24%22%

25%23%

22%22%

17%18%

21%

31%31%

28%24%28%

23%

23%32%

27%26%

31%25%

28%

47%46%41%41%

38%41%

43%34%

43%45%49%

50%

42%


Comfort with private organizations having de-identified health information decreases with age

Q24. How would you feel about sharing your de-identified health information with the following organizations?Private organizations such as drug companies or insurance companies.


© Harris/Decima

There is no consensus on who should control sharing information Q25-26. If your information was used in this way, and was shared with other doctors, hospitals and health researchers, who do you think

would/who would you prefer to have control of these data and make that decision?

Don't Know

Your hospital or health care organization

Your provincial government

Your doctor

You

0% 20% 40% 60% 80%

1%

8%

11%

35%

44%

6%

9%

26%

29%

30%

Would have control Would prefer to have control


0% 20% 40% 60% 80%

1%

11%

11%

33%

44%

4%

12%

25%

29%

30%

2012 2010

© Harris/Decima

No agreement on comfort with using identified information to track how well treatments were working

Q27. In rare cases, the use of your personal health information may contain your name or address. For example, if a doctor doing research needed to track the health of individuals to determine how well different treatments were working. Would you feel very

comfortable, somewhat comfortable, somewhat uncomfortable or very uncomfortable if your identified health information was used in this way?

2010

2012

0% 20% 40% 60% 80% 100%

13%

15%

32%

35%

29%

28%

24%

20%



© Harris/Decima

Comparison of Comfort/Concern about the General Concept of HSU vs. De-Identified vs. Identified Uses (top 2 box scores)

Identified use (Q27)

General concept (Q18)

De-identified use (Q19)

0% 20% 40% 60% 80% 100%

46%

48%

65%

50%

63%

70%

2012 2010


© Harris/Decima

Two in three continue to insist on requiring consent to use identified information

Q28. In cases like this, where you were identified, how would you feel about a requirement that your personal approval or consent would have to be given before your health information was used? Is this something that you insist upon, you would prefer but not insist upon or

something that you wouldn’t be concerned about and would not require your personal approval or consent?

2010

2012

0% 20% 40% 60% 80% 100%

67%

66%

22%

26%

9%

7%

Something I would insist upon Something I would prefer, but not insist upon Something I wouldn’t be concerned about


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

63%

64%

67%

66%

71%

65%

67%

65%

66%

28%

31%

28%

24%

24%

28%

25%

27%

26%

8%

5%

5%

8%

5%

6%

7%

7%

7%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

58%69%69%73%

68%53%

64%60%

66%65%69%

77%

66%

31%25%24%

22%24%

38%

23%30%

27%25%

25%19%

26%

9%5%7%3%8%9%

12%8%6%

10%5%4%

7%

Something I would insist upon Something I would prefer, but not insist upon Something I wouldn’t be concerned about

Those in BC most insistent on consentQ28. In cases like this, where you were identified, how would you feel about a requirement that your personal approval or consent would have to be given before your health information was used? Is this something that you insist upon, you would prefer but not insist upon or

something that you wouldn’t be concerned about and would not require you personal approval or consent?


© Harris/Decima

Three in four claim that they would give their consent for HSU of information

Q29. And if your approval or consent was required before your identified information could be used for health system purposes, do you think you would give your approval or consent or you would not give your approval or consent?

2010

2012

0% 20% 40% 60% 80% 100%

69%

77%

21%

13%

11%

10%

I would give my approval or consent I would NOT give my approval or consent Don't Know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

76%

84%

79%

76%

74%

80%

76%

79%

77%

12%

9%

14%

13%

17%

10%

14%

11%

13%

12%

7%

7%

11%

9%

10%

10%

10%

10%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

74%68%

79%81%83%

89%

85%76%77%

73%78%77%

77%

13%18%

9%15%9%

6%

9%17%

11%19%8%12%

13%

13%14%11%

4%9%5%

6%7%

12%8%

14%11%

10%

I would give my approval or consent I would NOT give my approval or consent Don't Know

Atlantic and younger Canadians most apt to give consent for health system uses of their information

Q29. And if your approval or consent was required before your identified information could be used for health system purposes, do you think you would give your approval or consent or you would not give your approval or consent?


© Harris/Decima

An increase in the number who would be more comfortable with an assessment process

Q30. Would you be more comfortable if you knew that the research project seeking to use identified information would have to go through an assessment process and be approved by an independent agency that would examine the potential risk to your privacy?

2010

2012

0% 20% 40% 60% 80% 100%

65%

71%

33%

26%

Yes, oversight adds comfort No, it makes no difference

Base: Those who insist on approval or consent before their health information was used or would not give approval for their identified information to be used (n=700)

© Harris/Decima

There has been an increase in the number of Canadians who would insist on providing consent and say that they would grant it


Insist on Consent Prefer Consent Wouldn’t care

2012 2010 2012 2010 2012 2010

Would grant 74% 64% 88% 77% 77% 81%

Would not grant 14% 22% 7% 15% 18% 18%

Don’t Know 12% 13% 5% 7% 5% 1%

© Harris/Decima

There is a growing number that views consent as adding comfort

Insist on Consent Prefer Consent Wouldn’t care

2012 2010 2012 2010 2012 2010

Oversight adds comfort

72% 67% 63% 40% 54% 39%

Makes no difference

25% 31% 37% 55% 42% 57%

Base: Those who insist on approval or consent before their health information was used or would not give approval for their identified information to be used (n=700)

© Harris/Decima

There has been a decline in the number who would not grant consent

Would insist on consent and would not grant

Would insist on consent and oversight would not add comfort

0% 5% 10% 15% 20% 25% 30%

15%

21%

9%

17%

2012 2010


© Harris/Decima

A strong majority expect their provider to notify them when their information is being used

Q31. Would you expect your doctor or care provider to notify you about when and how your personal information was being used for Health system purposes?

2010

2012

0% 20% 40% 60% 80% 100%

87%

86%

12%

13%

Yes, I would expect this No, I would not expect this


© Harris/Decima

On balance, half think HSU of de-identified information outweighs privacy concerns

Q32. Overall and on balance, what’s more important to you? Protecting the privacy of your health information or being able to use this de-identified information for Health system uses?

2010

2012

0% 20% 40% 60% 80% 100%

41%

56%

54%

39%

5%

5%

Being able to use this de-identified information for Health system uses Protecting the privacy of my health information Don't Know


© Harris/Decima

All over the place

Different places

Mostly in one place

All in one place

Don't have EMR

Have EMR

Female

Male

Total

0% 20% 40% 60% 80% 100%

58%

56%

60%

53%

49%

61%

57%

56%

56%

39%

36%

38%

42%

47%

34%

39%

40%

39%

3%

8%

2%

5%

4%

5%

5%

4%

5%

65+55-6445-5435-4425-3418-24

Atl.QCON

MB/SKABBC

Total

0% 20% 40% 60% 80% 100%

58%51%55%

52%59%

86%

57%59%

55%58%56%54%

56%

35%46%41%

41%41%

8%

40%37%

40%38%40%

41%

39%

7%3%4%

6%

6%

3%4%5%5%4%5%

5%

Being able to use this de-identified information for Health system usesProtecting the privacy of my health informationDon't Know

18 to 24 year olds most apt to place more importance on using de-identified information for health systems uses than on privacy

Q32. Overall and on balance, what’s more important to you? Protecting the privacy of your health information or being able to use this de-identified information for Health system uses?


© Harris/Decima

2012 public opinion research: canadian views on electronic health records this study was...

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majority of canadians

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