Patients' online access to their electronic health records and linked online services: a systematic review in primary care
Patients' online access to their electronic health records and linked online services: a systematic review in primary care
BACKGROUND: Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider.
AIM: To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care.
DESIGN AND SETTING: A systematic review was conducted that focused on all studies about online record access and transactional services in primary care.
METHOD: Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted.
RESULTS: A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy.
CONCLUSION: While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so.
Access to Information, Ambulatory Care Information Systems, Communication, Delivery of Health Care, Electronic Health Records, Humans, Patient Satisfaction, Primary Health Care, Journal Article, Research Support, Non-U.S. Gov't, Review
e141-51
Mold, Freda
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de Lusignan, Simon
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Sheikh, Aziz
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Majeed, Azeem
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Wyatt, Jeremy C.
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Quinn, Tom
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Cavill, Mary
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Franco, Christina
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Chauhan, Umesh
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Blakey, Hannah
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Kataria, Neha
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Arvanitis, Theodoros N
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Ellis, Beverley
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March 2015
Mold, Freda
dd4a20ed-a6fe-4178-847a-a4aaa6f1cf11
de Lusignan, Simon
d3a4897a-91dd-4880-b273-f92c2fe6c42f
Sheikh, Aziz
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Majeed, Azeem
856bd09f-2a1e-46c0-9377-e40c825fbaaf
Wyatt, Jeremy C.
8361be5a-fca9-4acf-b3d2-7ce04126f468
Quinn, Tom
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Cavill, Mary
10123360-4fa9-498d-8394-3b5cc0fc7d8e
Franco, Christina
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Chauhan, Umesh
61bc8745-c1e9-4cc7-a8e4-bb26012e4e66
Blakey, Hannah
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Kataria, Neha
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Arvanitis, Theodoros N
142a7f83-000d-4301-8372-1dce1c9aeaf7
Ellis, Beverley
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Mold, Freda, de Lusignan, Simon, Sheikh, Aziz, Majeed, Azeem, Wyatt, Jeremy C., Quinn, Tom, Cavill, Mary, Franco, Christina, Chauhan, Umesh, Blakey, Hannah, Kataria, Neha, Arvanitis, Theodoros N and Ellis, Beverley
(2015)
Patients' online access to their electronic health records and linked online services: a systematic review in primary care.
British Journal of General Practice, 65 (632), .
(doi:10.3399/bjgp15X683941).
Abstract
BACKGROUND: Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider.
AIM: To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care.
DESIGN AND SETTING: A systematic review was conducted that focused on all studies about online record access and transactional services in primary care.
METHOD: Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted.
RESULTS: A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy.
CONCLUSION: While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so.
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Accepted/In Press date: 1 July 2014
Published date: March 2015
Keywords:
Access to Information, Ambulatory Care Information Systems, Communication, Delivery of Health Care, Electronic Health Records, Humans, Patient Satisfaction, Primary Health Care, Journal Article, Research Support, Non-U.S. Gov't, Review
Organisations:
Faculty of Medicine
Identifiers
Local EPrints ID: 396599
URI: http://eprints.soton.ac.uk/id/eprint/396599
ISSN: 0960-1643
PURE UUID: a2427c1b-e487-432a-958e-43fd1904556b
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Date deposited: 08 Jun 2016 12:34
Last modified: 15 Mar 2024 03:53
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Contributors
Author:
Freda Mold
Author:
Simon de Lusignan
Author:
Aziz Sheikh
Author:
Azeem Majeed
Author:
Jeremy C. Wyatt
Author:
Tom Quinn
Author:
Mary Cavill
Author:
Christina Franco
Author:
Umesh Chauhan
Author:
Hannah Blakey
Author:
Neha Kataria
Author:
Theodoros N Arvanitis
Author:
Beverley Ellis
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