Patient Accessible Electronic Health Records for the Chronically Ill: A Review of the Literature

Abstract

Background: Consumers with chronic conditions account for approximately 70% of all healthcare spending. The Chronic Care Model is a healthcare paradigm whose purpose is the achievement of improved patient outcomes by facilitating the delivery of patient-centered, evidence-based care. We conducted a review of the literature to examine the role patient accessible electronic health records (PAEHR) may play in implementing and supporting the Chronic Care Model. Methods:A review of the literature was conducted using multiple databases . Publications included in the review were restricted to those using experimental or quasi-experimental methodology, English language and peer review. Results:Published results indicated that PAEHR facilitated improvements in health literacy and patient-provider communication, and that personalization of content was viewed favorably. Research on the use of PAEHR by some disease groups suggests improvements in clinical outcomes. Conclusions:The literature reviewed indicated that the patient experience for individuals with chronic illnesses could be enhanced through access to PAEHR. Improved satisfaction was noted for individuals with access to PAEHR with personalized content (e.g. lab results etc.). Use of PAEHR also improved patient-provider communication and increased personal knowledge and comprehension concerning individual condition and state of health. PAEHR for individuals living with chronic illnesses are an effective management technique that can help patients better manage the challenges of living with a chronic illness. These results indicate PAEHR have the potential to be a key component for actualizing the theoretical constructs of the Chronic Care Model by providing a platform for increased patient-provider collaboration.

Impact of patient-accessible electronic medical records in rheumatology: use, satisfaction and effects on empowerment among patients

“…Notable is that the portion of patients in our study that logged in to view their personal information is much larger than the portion that only viewed the general information on the patient web portal. Previous studies have also found that personal information, and especially laboratory results, are more useful than general information to patients with chronic conditions [13]. Concordantly, we can conclude that our portal with EMR access foresees in a need in these patients.…”

“…Most patients reported using the login service prior to a consultation, which could indicate that they used it to prepare for the conversation with their doctor or nurse [ 34 , 38 ]. Two recent systematic reviews on the effects of patient web portals with EMR access show that only a few other studies have included empowerment-related outcomes into their evaluations, with small and inconclusive results [ 13 , 10 ]. Tuil et al [ 9 ], who conducted a study among patients undergoing IVF treatment, could not detect any enhancement in patient empowerment over time either.…”

“…First of all, it increases transparency of medical data, which could reduce medical errors, increase patients’ trust in care providers and could enhance patient satisfaction [ 10 - 12 ]. Secondly, patients’ knowledge and understanding of the disease and treatment may be enhanced [ 13 ], increasing their involvement in decision making processes [ 13 , 14 ]. Thirdly, patients may feel more control over their disease and treatment, which could positively influence treatment adherence [ 15 ], and even clinical outcomes [ 16 ].…”

Empowering Senior Cochlear Implant Users at Home via a Tablet Computer Application

“…From the patient's perspective, participants were very keen on having access to the Recipient Portal. Research has shown that having access to personalized information is more useful compared with having access to general information of patients with chronic conditions (e.g., Urowitz et al, 2012). In the current study, most participants found it very useful having personalized information (e.g., warranty information) at a single location, accessible at any time.…”

Connecting Families to Their Health Record and Care Team: The Use, Utility, and Impact of a Client/Family Health Portal at a Children’s Rehabilitation Hospital

“…Systematic reviews on the effects of portals with EHR access [ 25 - 27 ] indicate that few studies have investigated outcomes concerning patient engagement or empowerment, with studies typically providing nonsignificant findings. Kruse et al [ 27 ] found only 27 studies of relevance to impact—those measuring meaningful outcomes such as patient participation in medical decisions, patient-provider communication, or satisfaction.…”