Negotiating stigma in health care: disclosure and the role of electronic health records

The implementation of electronic health records facilitates information sharing which can create challenges for stigma management and disclosure during the clinical encounter. Building on theories of stigma management, we analysed 30 in-depth interviews of sexual minority men in the USA to explore how they perceived the role of electronic health records in the clinical encounter in general and for disclosure in particular. Participants expressed concerns about privacy but also saw potential benefits to electronic health records. Similarly, while some thought electronic health records improved communication with providers, others experienced the electronic health record as a barrier to open and trusting communication. New information technologies are changing health-care encounters, but present a double-edged sword that underscores the challenge of negotiating health care for stigmatised individuals. It remains to be seen if information technology will enhance care for all or further alienate already apprehensive health seekers from disclosing personal health information.