Mental Health Care Professionals’ Appraisal of Patients’ Use of Web-Based Access to Their Electronic Health Record: Qualitative Study

Rijt, Antonius Mattheus van; Hulter, Pauline; Weggelaar-Jansen, Anne Marie; Ahaus, Kees; Pluut, Bettine

doi:10.2196/28045

Cited by 18 publications

(39 citation statements)

References 35 publications

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“…The research team developed a standardized template to extract and chart relevant data from the included studies [5,[12][13][14][15][16][17][18][19][20][21][22][23][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]. The following parameters were recorded in detail: reference ID, authors, year, country, design, sample, participants, treatment setting and medical specialty, study purpose, and a summary of the results.…”

Section: Data Extraction and Managementmentioning

confidence: 99%

“…The following parameters were recorded in detail: reference ID, authors, year, country, design, sample, participants, treatment setting and medical specialty, study purpose, and a summary of the results. The data were extracted by JS and AB, and checked for accuracy and completeness by CB (see Multimedia Appendix 2 [5,[12][13][14][15][16][17][18][19][20][21][22][23][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] for more information).…”

Section: Data Extraction and Managementmentioning

confidence: 99%

“…Instead, a detailed description of the quality of the included studies is provided based on the MMAT grading results. A comprehensive presentation of the individual ratings of each criterion can be found in Multimedia Appendix 3 [5,[12][13][14][15][16][17][18][19][20][21][22][23][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56].…”

Section: Quality Assessment Of Studiesmentioning

confidence: 99%

“…Study design [12,15,16,18,[21][22][23]39,50,51] 10 (32) Qualitative [5,13,14,17,40,43,45,48,49 13) Psychotherapy [5,14,16,17,19,20,23,45,47,48,50,55,56] 13 (42) Psychiatry [13,15,22,[39][40][41][42][43]52] 9 (29) Veterans Affairs Mental Health [5,21,44,48,49,51] 6 (19) Somatic (General practitioner, Primary Care and other) …”

Section: References Total N (%) Parametermentioning

confidence: 99%

“…HCPs also report concerns that providing access to SUs will reduce clinicians' autonomy [14][15][16][17] and encroach on the quality of documentation [5,[13][14][15][16][17][18][19][20]. Fears about additional workplace burdens [13,14,[16][17][18]21,22], increased time spent responding to SUs' anxieties, or misunderstandings about their clinical documentation [13,14,16,17,23] are additional concerns.…”

Section: Introductionmentioning

confidence: 99%

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Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review

Schwarz¹,

Bärkås²,

Blease³

et al. 2021

JMIR Ment Health

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Background Electronic health records (EHRs) are increasingly implemented internationally, whereas digital sharing of EHRs with service users (SUs) is a relatively new practice. Studies of patient-accessible EHRs (PAEHRs)—often referred to as open notes—have revealed promising results within general medicine settings. However, studies carried out in mental health care (MHC) settings highlight several ethical and practical challenges that require further exploration. Objective This scoping review aims to map available evidence on PAEHRs in MHC. We seek to relate findings with research from other health contexts, to compare different stakeholders’ perspectives, expectations, actual experiences with PAEHRs, and identify potential research gaps. Methods A systematic scoping review was performed using 6 electronic databases. Studies that focused on the digital sharing of clinical notes or EHRs with people affected by mental health conditions up to September 2021 were included. The Mixed Methods Appraisal Tool was used to assess the quality of the studies. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Extension for Scoping Reviews guided narrative synthesis and reporting of findings. Results Of the 1034 papers screened, 31 were included in this review. The studies used mostly qualitative methods or surveys and were predominantly published after 2018 in the United States. PAEHRs were examined in outpatient (n=29) and inpatient settings (n=11), and a third of all research was conducted in Veterans Affairs Mental Health. Narrative synthesis allowed the integration of findings according to the different stakeholders. First, SUs reported mainly positive experiences with PAEHRs, such as increased trust in their clinician, health literacy, and empowerment. Negative experiences were related to inaccurate notes, disrespectful language use, or uncovering of undiscussed diagnoses. Second, for health care professionals, concerns outweigh the benefits of sharing EHRs, including an increased clinical burden owing to more documentation efforts and possible harm triggered by reading the notes. Third, care partners gained a better understanding of their family members’ mental problems and were able to better support them when they had access to their EHR. Finally, policy stakeholders and experts addressed ethical challenges and recommended the development of guidelines and trainings to better prepare both clinicians and SUs on how to write and read notes. Conclusions PAEHRs in MHC may strengthen user involvement, patients’ autonomy, and shift medical treatment to a coproduced process. Acceptance issues among health care professionals align with the findings from general health settings. However, the corpus of evidence on digital sharing of EHRs with people affected by mental health conditions is limited. Above all, further research is needed to examine the clinical effectiveness, efficiency, and implementation of this sociotechnical intervention.

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Section: Data Extraction and Managementmentioning

confidence: 99%

Section: Data Extraction and Managementmentioning

confidence: 99%

Section: Quality Assessment Of Studiesmentioning

confidence: 99%

Section: References Total N (%) Parametermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review

Schwarz¹,

Bärkås²,

Blease³

et al. 2021

JMIR Ment Health

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Pre-implementation perceptions of clinicians regarding a patient portal in inpatient addictions settings: A qualitative descriptive study

Ling,

Kassam,

Haider

et al. 2023

International Journal of Medical Informatics

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The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

Reynolds,

Cobb,

Steitz

et al. 2023

Appl Clin Inform

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Background and Objective Recent external factors—the 21st Century Cures Act and the coronavirus disease 2019 (COVID-19) pandemic—have stimulated major changes in the patient portal landscape. The objective of this state-of-the-art review is to describe recent developments in the patient portal literature and to identify recommendations and future directions for the design, implementation, and evaluation of portals. Methods To focus this review on salient contemporary issues, we elected to center it on four topics: (1) 21st Century Cures Act's impact on patient portals (e.g., Open Notes); (2) COVID-19's pandemic impact on portals; (3) proxy access to portals; and (4) disparities in portal adoption and use. We conducted targeted PubMed searches to identify recent empirical studies addressing these topics, used a two-part screening process to determine relevance, and conducted thematic analyses. Results Our search identified 174 unique papers, 74 were relevant empirical studies and included in this review. Among these papers, we identified 10 themes within our four a priori topics, including preparing for and understanding the consequences of increased patient access to their electronic health information (Cures Act); developing, deploying, and evaluating new virtual care processes (COVID-19); understanding current barriers to formal proxy use (proxy access); and addressing disparities in portal adoption and use (disparities). Conclusion Our results suggest that the recent trends toward understanding the implications of immediate access to most test results, exploring ways to close gaps in portal adoption and use among different sub-populations, and finding ways to leverage portals to improve health and health care are the next steps in the maturation of patient portals and are key areas that require more research. It is important that health care organizations share their innovative portal efforts, so that successful measures can be tested in other contexts, and progress can continue.

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Mental Health Care Professionals’ Appraisal of Patients’ Use of Web-Based Access to Their Electronic Health Record: Qualitative Study

Cited by 18 publications

References 35 publications

Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review

Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review

Pre-implementation perceptions of clinicians regarding a patient portal in inpatient addictions settings: A qualitative descriptive study

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

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