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Patients' online access to their electronic health records and linked online services : a systematic interpretative review
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Lusignan, Simon de, Mold, Freda, Sheikh, Aziz, Majeed, Azeem, Wyatt, Jeremy C., Quinn, Tom, Cavill, Mary, Gronlund, Toto Anne, Franco, Christina, Chauhan, Umesh, Blakey, Hannah, Kataria, Neha, Barker, Fiona, Ellis, Bev, Koczan, Phil, Arvanitis, Theodoros N., McCarthy, Mary, Jones, Simon and Rafi, Imran (2014) Patients' online access to their electronic health records and linked online services : a systematic interpretative review. BMJ Open, Volume 4 (Number 9). Article number e006021. doi:10.1136/bmjopen-2014-006021 ISSN 2044-6055.
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Official URL: http://dx.doi.org/10.1136/bmjopen-2014-006021
Abstract
Objectives To 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.
Setting Primary care.
Participants A 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 measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services.
Results No 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.
Conclusions Patient 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.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group) | ||||||||
Library of Congress Subject Headings (LCSH): | Medical records -- Data processing, Self-care, Health | ||||||||
Journal or Publication Title: | BMJ Open | ||||||||
Publisher: | BMJ | ||||||||
ISSN: | 2044-6055 | ||||||||
Official Date: | 8 September 2014 | ||||||||
Dates: |
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Volume: | Volume 4 | ||||||||
Number: | Number 9 | ||||||||
Article Number: | Article number e006021 | ||||||||
DOI: | 10.1136/bmjopen-2014-006021 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Date of first compliant deposit: | 28 December 2015 | ||||||||
Date of first compliant Open Access: | 28 December 2015 | ||||||||
Funder: | Royal College of General Practitioners (RCGP) |
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