Doctors’ orders or patients’ preferences? Examining the role of physicians in patients’ privacy decisions on health information exchange platforms

Health information exchange (HIE) platforms could increase the efficiency of health care services by enabling providers to instantly access the medical records of their patients. However, these benefits cannot be realized unless patients disclose their information on HIE platforms. We examine actual privacy decisions made by patients on an HIE platform, study the influence of physicians’ recommendations on patients’ decisions, and explore the process through which this effect takes place. By analyzing a unique data set consisting of the privacy decisions of 12,444 patients, we show that contrary to common belief, patients do not simply follow physician recommendations, but rather carefully consider the risks and benefits of providing consent. We show that competition among medical providers does not hinder patient participation in HIEs, but that providers’ decisions to ask for consent are primarily driven by the potential benefits of HIE for themselves and their patients.