The challenges in making electronic health records accessible to patients: Table 1

Beard, Leslie; Schein, Rebecca; Morra, Dante; Wilson, Kumanan; Keelan, Jennifer

doi:10.1136/amiajnl-2011-000261

Cited by 93 publications

(79 citation statements)

References 25 publications

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“…These medicolegal concerns have been echoed in other international studies 5. The tensions between the growing consumer demand to access data and a healthcare system not yet ready to meet these demands have increased in recent years 6 7. The promise of linking personal records from multiple sources into a readily digestible single online record has not yet been realised 8 9.…”

Section: Introductionmentioning

confidence: 99%

Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

et al. 2014

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ObjectivesTo investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues.SettingPrimary care.ParticipantsA total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol.Primary and secondary outcome measuresOur primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services.ResultsNo studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt.ConclusionsPatient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients.A1. Systematic review registration numberPROSPERO CRD42012003091.

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Section: Introductionmentioning

confidence: 99%

Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

et al. 2014

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“…A current issue with electronic health record systems is often they cannot exchange or share information. 71 If a patient is seeing a family physician and a specialist, and the two providers have different EHR systems, information cannot be exchanged or shared. Patients frequently receive care from multiple healthcare providers making this an issue for many of Americans.…”

Section: Discussionmentioning

confidence: 99%

Uncovering patterns of technology use in consumer health informatics

Hung

Conrad

Hon

et al. 2013

WIREs Computational Stats

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Internet usage and accessibility has grown at a staggering rate, influencing technology use for healthcare purposes. The amount of health information technology (Health IT) available through the Internet is immeasurable and growing daily. Health IT is now seen as a fundamental aspect of patient care as it stimulates patient engagement and encourages personal health management. It is increasingly important to understand consumer health IT patterns including who is using specific technologies, how technologies are accessed, factors associated with use, and perceived benefits. To fully uncover consumer patterns it is imperative to recognize common barriers and which groups they disproportionately affect. Finally, exploring future demand and predictions will expose significant opportunities for health IT. The most frequently used health information technologies by consumers are gathering information online, mobile health (mHealth) technologies, and personal health records (PHRs). Gathering health information online is the favored pathway for healthcare consumers as it is used by more consumers and more frequently than any other technology. In regard to mHealth technologies, minority Americans, compared with White Americans utilize social media, mobile Internet, and mobile applications more frequently. Consumers believe PHRs are the most beneficial health IT. PHR usage is increasing rapidly due to PHR integration with provider health systems and health insurance plans. Key issues that have to be explicitly addressed in health IT are privacy and security concerns, health literacy, unawareness, and usability. Privacy and security concerns are rated the number one reason for the slow rate of health IT adoption.

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“…T e vision of a "learning health-care system" in which all these data can be used for quality improvement and for health services or patient-centered outcomes research is sensible, but enabling this system is not simple (8). Furthermore, it is not trivial to track data usage to address the public's increasing interest in guarding their own records (9) and in understanding how data and specimens obtained for one purpose (for example, health care or a specif c study) are being used for other purposes, such as secondary analyses in other studies (10). Because of the high stakes, not all health care organizations have bought into the idea of data sharing; other than the technical challenges, prerequisites such as a system of incentives and a clear business model have to be developed.…”

Section: Care To Share?mentioning

confidence: 99%