Providing patients online access to their primary care computerised
medical records: a case study of sharing and caring

Hannan, Amir

doi:10.14236/jhi.v18i1.752

Cited by 26 publications

(32 citation statements)

References 5 publications

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“…13 Pilot studies demonstrate the feasibility of providing online access. 14,15 'Online access' is generally subdivided into access to the medical record itself; provision of e-mail or an equivalent messaging service through a portal; and 'transactional services' such as requesting a repeat prescription or booking an appointment. In the US, Kaiser Permanente has had success in securing two-thirds of its 3.4 million members to sign up for online appointment booking, viewing test results, and e-mail.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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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.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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“…The promise of linking personal records from multiple sources into a readily digestible single online record has not yet been realised 8 9. Plans to provide patients online access10 have been successfully piloted,11 but not widely adopted. Patients were concerned about the relative brevity of the record and that any mistakes, though few, could be clinically significant 12.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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ObjectivesTo 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.SettingPrimary care.ParticipantsA 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 measuresOur primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services.ResultsNo 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.ConclusionsPatient 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.A1. Systematic review registration numberPROSPERO CRD42012003091.

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“…Even where pilot sites report success and benefit, there remain unresolved issues regarding online access for children, those reliant on carers or those in abusive relationships. 12 …”

Section: Safeguards Proposed To Datementioning

confidence: 99%

Online access to medical records: finding ways to minimise harms

Woodman

Sohal²,

Gilbert

et al. 2015

Br J Gen Pract

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Providing patients online access to their primary care computerised medical records: a case study of sharing and caring

Cited by 26 publications

References 5 publications

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

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

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

Online access to medical records: finding ways to minimise harms

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