Patient access to medical records and healthcare outcomes: a systematic review

Giardina, Traber Davis; Menon, Shailaja; Parrish, Danielle E.; Sittig, Dean F.; Singh, Hardeep

doi:10.1136/amiajnl-2013-002239

Cited by 116 publications

(111 citation statements)

References 50 publications

(57 reference statements)

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“…After removing duplicates and initial screening of titles and abstracts, 42 papers were retrieved for detailed evaluation. [24,25,26] which were part of another main study [6,27,28], leading to a total of 20 unique reviews [3,6,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The overall process of review selection was …”

Section: Search Resultsmentioning

confidence: 99%

“…Patients reported some evidence of improvements in safety through identifying medication errors, self-care, communication and engagement with clinicians [27]. There were no reports of harm to patients, such as increased anxiety, a common fear endorsed by physicians [33], nor breaches in privacy [27]. However, some participants were concerned about privacy and security [43].…”

Section: Narrative Synthesis Of the Evidence Of Benefitsmentioning

confidence: 99%

Section: Narrative Synthesis Of the Evidence Of Benefitsmentioning

confidence: 99%

“…Three out of five reviews focusing on the effects of providing patients access to their EHR found improved levels of patient satisfaction [27,33,36]. However, evidence was less clear for effects on quality [33]. There have been only few RCTs examining the effectiveness of online access to EHR on improving health outcomes, but some work has been undertaken focusing on the impact on patient decision making and health outcomes [27].…”

Section: Narrative Synthesis Of the Evidence Of Benefitsmentioning

confidence: 99%

See 3 more Smart Citations

Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews (Preprint)

Zanaboni¹,

Ngangue²,

Mbemba³

et al. 2018

Preprint

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Section: Search Resultsmentioning

confidence: 99%

Section: Narrative Synthesis Of the Evidence Of Benefitsmentioning

confidence: 99%

Section: Narrative Synthesis Of the Evidence Of Benefitsmentioning

confidence: 99%

Section: Narrative Synthesis Of the Evidence Of Benefitsmentioning

confidence: 99%

See 2 more Smart Citations

Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews (Preprint)

Zanaboni¹,

Ngangue²,

Mbemba³

et al. 2018

Preprint

View full text Add to dashboard Cite

show abstract

“…4,6,[8][9][10] To date, these technologies have been demonstrated to have only modest effects on healthcare, 11,12 although some features and programs have been associated with improved outcomes affecting health care utilization, medication adherence, patient perceptions, and medication reconciliation. [11][12][13][14] A variety of challenges have been identified that may be hindering uptake and effectiveness of these portals. Some patients have limited access to computers or to broadband Internet, 15 and the highly technical information in portals may not be easily usable by patients with limited health literacy.…”

Section: Introductionmentioning

confidence: 99%

Rapid Growth in Use of Personal Health Records in New York, 2012–2013

2014

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BACKGROUND:Giving patients access to their own medical data may help improve communication and engage patients in healthcare. As a result, the federal electronic health record (EHR) incentive program requires providers to offer electronic data sharing with patients via personal health records (PHRs) or other technologies. OBJECTIVE: We sought to estimate the rate of adoption of PHRs over a 2-year period. DESIGN: Survey of 800 respondents (margin of error: 3.5 percentage points) in consecutive years of the Empire State Poll, an annual random-digit-dial telephone survey. PARTICIPANTS: Adult New York State residents. MAIN MEASURES: Self-reported use of a PHR. KEY RESULTS: The rate of reported PHR use rose from 11 % in 2012 to 17 % in 2013. The proportion of these PHRs provided by doctors or healthcare organizations also increased sharply (from 50 % in 2012 to 73 % in 2013, p<0.01) with a corresponding decrease in the proportion provided by insurers. CONCLUSIONS: The proportion of New York State residents using PHRs increased by more than 50 % (from 11 to 17 %) in advance of a federal incentive program requirement that healthcare organizations with EHRs must share electronic data with patients in order to receive their incentives.

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Unsolicited Patient Complaints Following the 21st Century Cures Act Information-Blocking Rule

Dambrino,

Domenico,

Graves

et al. 2023

JAMA Health Forum

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ImportanceThe 21st Century Cures Act includes an information-blocking rule (IBR) that requires health systems to provide patients with immediate access to their health information in the electronic medical record upon request. Patients accessing their health information before they receive an explanation from their health care team may experience confusion and may be more likely to share unsolicited patient complaints (UPCs) with their health care organization.ObjectiveTo evaluate the quantity of UPCs about physicians before and after IBR implementation and to identify themes in UPCs that may identify patient confusion, fear, or anger related to the release of information.Design, Setting, and ParticipantsThis retrospective cohort study was conducted with an interrupted time-series analysis of UPCs spanning January 1, 2020, to June 30, 2022. The data were obtained from a single academic medical center, Vanderbilt University Medical Center, at which the IBR was implemented on January 20, 2021. Data analysis was performed from January 11 to July 15, 2023.ExposureImplementation of the IBR on January 20, 2021.Main Outcomes and MeasuresThe primary outcome was the monthly rate of UPCs before and after IBR implementation. A qualitative analysis was performed for UPCs received after IBR implementation. The Wilcoxon rank-sum test was used to compare monthly complaints between the pre- and post-IBR groups. The Pearson χ2 test was used to compare proportions of complaints by UPC category between time periods.ResultsThe medical center received 8495 UPCs during the study period: 3022 over 12 months before and 5473 over 18 months after institutional IBR implementation. There was no difference in the monthly proportions of UPCs per 1000 patient encounters before (median, 0.81 [IQR, 0.75-0.88]) and after (median, 0.83 [IQR, 0.77-0.89]) IBR implementation (difference in medians, −0.02 [95% CI, −0.12 to 0.07]; P =.86). Segmented regression analysis revealed no difference in monthly UPCs (β [SE], 0.03 [0.09]; P =.72).Conclusions and RelevanceIn this cohort study, implementation of the Cures Act IBR was not associated with an increase in monthly rates of UPCs. These findings suggest that review of UPCs identified as IBR-specific complaints may allow clinicians and organizations to prepare patients that their test and procedure results may be available before clinicians are able to review them and respond.

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Patient access to medical records and healthcare outcomes: a systematic review

Abstract: Although few positive findings generally favored patient access, the literature is unclear on whether providing patients access to their medical records improves quality.

Cited by 116 publications

References 50 publications

Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews (Preprint)

Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews (Preprint)

Rapid Growth in Use of Personal Health Records in New York, 2012–2013

Unsolicited Patient Complaints Following the 21st Century Cures Act Information-Blocking Rule

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