Evidence that patient portals improve health outcomes, cost, or utilization is insufficient. Patient attitudes are generally positive, but more widespread use may require efforts to overcome racial, ethnic, and literacy barriers. Portals represent a new technology with benefits that are still unclear. Better understanding requires studies that include details about context, implementation factors, and cost.

ABSTRACT:To understand what is new in health information technology (IT), we updated a systematic review of health IT with studies published during [2004][2005][2006][2007]. From 4,683 titles, 179 met inclusion criteria. We identified a proliferation of patient-focused applications although little formal evaluation in this area; more descriptions of commercial electronic health records (EHRs) and health IT systems designed to run independently from EHRs; and proportionately fewer relevant studies from the health IT leaders. Accelerating the adoption of health IT will require greater public-private partnerships, new policies to address the misalignment of financial incentives, and a more robust evidence base regarding IT implementation. [Health Affairs 28, no. 2 (2009) T h e us e o f h e a lt h i n f o r m at i o n t e c h n o l o gy (IT) has been promoted as having tremendous promise in improving the efficiency, costeffectiveness, quality, and safety of medical care delivery. In a systematic review of the literature commissioned by the Agency for Healthcare Research and Quality (AHRQ) and performed in 2005, we assessed the published evidence regarding the costs and benefits of clinical health IT systems. We found that although predictive analyses suggest that health IT has the potential to enable a dramatic transformation in health care delivery, the empirical research evidence base supporting its benefits is limited. 1 The preponderance of the favorable evidence came from a few large organizations (which we dubbed the "health IT leaders") that have implemented multifunctional, interoperable electronic health records (EHRs) that include computerized physician order entry (CPOE), decisionw 2 8 2 2 7 J a n u a r y 2 0 0 9

U.S. Department of Veterans Affairs. (PROSPERO registration number: CRD42014007469).

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