"Nothing About Me Without Me": An Interpretative Review of Patient Accessible Electronic Health Records
File(s)
Author(s)
Jilka, SR
Callahan, R
Sevdalis, N
Mayer, EK
Darzi, A
Type
Journal Article
Abstract
Background
Patient accessible electronic health records (PAEHRs) enable patients to access and manage personal
clinical information that is made available to them by their health care providers (HCPs). It is thought that
the shared management nature of medical record access improves patient outcomes and improves patient
satisfaction. However, recent reviews have found that this is not the case. Furthermore, little research has
focused on PAEHRs from the HCP viewpoint. HCPs include physicians, nurses, and service providers.
Objective
We provide a systematic review of reviews of the impact of giving patients record access from both a
patient and HCP point of view. The review covers a broad range of outcome measures, including patient
safety, patient satisfaction, privacy and security, self-efficacy, and health outcome.
Methods
A systematic search was conducted using Web of Science to identify review articles on the impact of
PAEHRs. Our search was limited to English-language reviews published between January 2002 and
November 2014. A total of 73 citations were retrieved from a series of Boolean search terms including
“review*” with “patient access to records”. These reviews went through a novel scoring system analysis
whereby we calculated how many positive outcomes were reported per every outcome measure
investigated. This provided a way to quantify the impact of PAEHRs.
Results
1 1 2 1
1
1
2
Ten reviews covering chronic patients (eg, diabetes and hypertension) and primary care patients, as well as
HCPs were found but eight were included for the analysis of outcome measures. We found mixed
outcomes across both patient and HCP groups, with approximately half of the reviews showing positive
changes with record access. Patients believe that record access increases their perception of control;
however, outcome measures thought to create psychological concerns (such as patient anxiety as a result of
seeing their medical record) are still unanswered. Nurses are more likely than physicians to gain time
efficiencies by using a PAEHR system with the main concern from physicians being the security of the
PAEHRs.
Conclusions
This review implements a novel scoring system, which shows there is a lack of rigorous empirical testing
that separates the effect of record access from other existing disease management programs. Current
research is too targeted within certain clinical groups’ needs, and although there are positive signs for the
adoption of PAEHRs, there is currently insufficient evidence about the effect of PAEHRs on health
outcomes for patients or HCPs.
Patient accessible electronic health records (PAEHRs) enable patients to access and manage personal
clinical information that is made available to them by their health care providers (HCPs). It is thought that
the shared management nature of medical record access improves patient outcomes and improves patient
satisfaction. However, recent reviews have found that this is not the case. Furthermore, little research has
focused on PAEHRs from the HCP viewpoint. HCPs include physicians, nurses, and service providers.
Objective
We provide a systematic review of reviews of the impact of giving patients record access from both a
patient and HCP point of view. The review covers a broad range of outcome measures, including patient
safety, patient satisfaction, privacy and security, self-efficacy, and health outcome.
Methods
A systematic search was conducted using Web of Science to identify review articles on the impact of
PAEHRs. Our search was limited to English-language reviews published between January 2002 and
November 2014. A total of 73 citations were retrieved from a series of Boolean search terms including
“review*” with “patient access to records”. These reviews went through a novel scoring system analysis
whereby we calculated how many positive outcomes were reported per every outcome measure
investigated. This provided a way to quantify the impact of PAEHRs.
Results
1 1 2 1
1
1
2
Ten reviews covering chronic patients (eg, diabetes and hypertension) and primary care patients, as well as
HCPs were found but eight were included for the analysis of outcome measures. We found mixed
outcomes across both patient and HCP groups, with approximately half of the reviews showing positive
changes with record access. Patients believe that record access increases their perception of control;
however, outcome measures thought to create psychological concerns (such as patient anxiety as a result of
seeing their medical record) are still unanswered. Nurses are more likely than physicians to gain time
efficiencies by using a PAEHR system with the main concern from physicians being the security of the
PAEHRs.
Conclusions
This review implements a novel scoring system, which shows there is a lack of rigorous empirical testing
that separates the effect of record access from other existing disease management programs. Current
research is too targeted within certain clinical groups’ needs, and although there are positive signs for the
adoption of PAEHRs, there is currently insufficient evidence about the effect of PAEHRs on health
outcomes for patients or HCPs.
Date Issued
2015-06-01
Date Acceptance
2015-05-24
Citation
Journal of Medical Internet Research, 2015, 17 (6)
ISSN
1439-4456
Publisher
Journal of Medical Internet Research
Journal / Book Title
Journal of Medical Internet Research
Volume
17
Issue
6
Copyright Statement
©Sagar Ramesh Jilka, Ryan Callahan, Nick Sevdalis, Erik K Mayer, Ara Darzi. Originally published in the Journal of Medical
Internet Research (http://www.jmir.org), 29.06.2015.
This is an open-access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to
the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
Internet Research (http://www.jmir.org), 29.06.2015.
This is an open-access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to
the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
Subjects
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
patient accessible electronic health records
online record access
INTENSIVE-CARE-UNIT
MEDICAL-RECORDS
INFORMATION-SYSTEM
TIME
DOCUMENTATION
NURSES
IMPACT
PORTALS
PHYSICIANS
EFFICIENCY
Publication Status
Published
Article Number
e161