The Digitization of Healthcare: Boundary Risks, Emotion, and Consumer Willingness to Disclose Personal Health Information

Abstract

As healthcare becomes increasingly digitized, the promise of improved care enabled by technological advances inevitably must be traded off against any unintended negative consequences. There is little else that is as consequential to an individual as his or her health. In this context, the privacy of one's personal health information has escalated as a matter of significant concern for the public. We pose the question: under what circumstances will individuals be willing to disclose identified personal health information and permit it to be digitized? Using privacy boundary theory and recent developments in the literature related to risk-as-feelings as the core conceptual foundation, we propose and test a model explicating the role played by type of information requested (general health, mental health, genetic), the purpose for which it is to be used (patient care, research, marketing), and the requesting stakeholder (doctors/hospitals, the government, pharmaceutical companies) in an individual's willingness to disclose personal health information. Furthermore, we explore the impact of emotion linked to one's health condition on willingness to disclose. Results from a nationally representative sample of over 1,000 adults underscore the complexity of the health information disclosure decision and show that emotion plays a significant role, highlighting the need for re-examining the timing of consent. Theoretically, the study extends the dominant cognitive-consequentialist approach to privacy by incorporating the role of emotion. It further refines the privacy calculus to incorporate the moderating influence of contextual factors salient in the healthcare setting. The practical implications of this study include an improved understanding of consumer concerns and potential impacts regarding the electronic storage of health information that can be used to craft policy.