Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial

Schnipper, Jeffrey L.; Gandhi, Tejal K.; Wald, Jonathan S.; Grant, Richard W.; Poon, Eric G.; Businger, Alexandra; Williams, Deborah H.; Siteman, Elizabeth; Buckel, Lauren; Middleton, Blackford

doi:10.1136/amiajnl-2011-000723

Cited by 78 publications

(107 citation statements)

References 19 publications

Supporting

Mentioning

106

Contrasting

Order By: Relevance

“…41 Three were cluster randomised control trials. [42][43][44] One study was defined as using a quasi-experimental non-randomised design. 45 Most of these studies originated from the US (n = 13), with three studies being undertaken in Norway, and only one from the UK.…”

Section: Discussionmentioning

confidence: 99%

“…43 Patients given access to their medication list online corrected more than twice as many medication discrepancies with potential for severe harm (0.03 versus 0.08 per patient, adjusted risk ratio 0.31, 95% CI = 0.10 to 0.92; P = 0.04). 43 Online access to consultation notes was also found to increase reported medication adherence as 60-78% (n = 5391) of patients taking medications reported increased adherence. 45 Online services facilitated uptake of preventive care services by providing prevention or health maintenance reminders.…”

Section: 35mentioning

confidence: 99%

“…45 The studies about medication safety (inevitably) lacked allocation concealment and these papers reported blinding was not applicable to their study methods. 42,43,45 The prevention outcomes studies had low risk of bias (Figure 3). …”

Section: 35mentioning

confidence: 99%

“…Outcomes of these studies varied, with most focusing specifically on online record access, 39 or online service utilisation, 30,34,37,[40][41][42] including impact on workload, 31,45 and attendance rates. 32 Several focused on patient or provider satisfaction; 29,35,38,44 two on patient safety, medication accuracy, 43 and preventive reminders; 36 and one study on willingness to pay for electronic communication with their GP. 33 These studies were subject to RoB assessment.…”

Section: 35 37mentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2015

View full text Add to dashboard Cite

BackgroundOnline access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. AimTo assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and settingA systematic review was conducted that focused on all studies about online record access and transactional services in primary care. MethodData sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012. The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. ResultsA total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved selfcare, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. ConclusionWhile the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: 35mentioning

confidence: 99%

Section: 35mentioning

confidence: 99%

Section: 35 37mentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2015

View full text Add to dashboard Cite

show abstract

“…[13,14] Patient safety could be improved through identifying errors in medication lists. [15,16] Moreover, providing online access could lower the threshold for patientclinician contact. [12] Quality of care can also be improved by sustained use of some features of a Patient Portal.…”

mentioning

confidence: 99%