Ammenwerth Elske, Schnell-Inderst Petra, Hoerbst Alexander
Institute of Health Informatics, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria.
J Med Internet Res. 2012 Nov 26;14(6):e162. doi: 10.2196/jmir.2238.
Modern information technology is changing and provides new challenges to health care. The emergence of the Internet and the electronic health record (EHR) has brought new opportunities for patients to play a more active role in his/her care. Although in many countries patients have the right to access their clinical information, access to clinical records electronically is not common. Patient portals consist of provider-tethered applications that allow patients to electronically access health information that are documented and managed by a health care institution. Although patient portals are already being implemented, it is still unclear in which ways these technologies can influence patient care.
To systematically review the available evidence on the impact of electronic patient portals on patient care.
A systematic search was conducted using PubMed and other sources to identify controlled experimental or quasi-experimental studies on the impact of patient portals that were published between 1990 and 2011. A total of 1,306 references from all the publication hits were screened, and 13 papers were retrieved for full text analysis.
We identified 5 papers presenting 4 distinct studies. There were no statistically significant changes between intervention and control group in the 2 randomized controlled trials investigating the effect of patient portals on health outcomes. Significant changes in the patient portal group, compared to a control group, could be observed for the following parameters: quicker decrease in office visit rates and slower increase in telephone contacts; increase in number of messages sent; changes of the medication regimen; and better adherence to treatment.
The number of available controlled studies with regard to patient portals is low. Even when patient portals are often discussed as a way to empower patients and improve quality of care, there is insufficient evidence to support this assumption.
现代信息技术正在发生变革，并给医疗保健带来了新的挑战。互联网和电子健康记录（EHR）的出现为患者在其医疗护理中发挥更积极的作用带来了新机遇。尽管在许多国家患者有权获取其临床信息，但通过电子方式获取临床记录并不常见。患者门户由与医疗机构相关联的应用程序组成，这些程序允许患者以电子方式访问由医疗机构记录和管理的健康信息。尽管患者门户已经在实施，但这些技术能够以何种方式影响患者护理仍不明确。
系统评价关于电子患者门户对患者护理影响的现有证据。
使用PubMed和其他来源进行系统检索，以识别1990年至2011年期间发表的关于患者门户影响的对照实验或准实验研究。对所有检索到的出版物中的1306篇参考文献进行筛选，检索出13篇论文进行全文分析。
我们识别出5篇论文呈现了4项不同的研究。在两项调查患者门户对健康结局影响的随机对照试验中，干预组和对照组之间没有统计学上的显著变化。与对照组相比，在患者门户组中可观察到以下参数有显著变化：门诊就诊率更快下降，电话联系增加更缓慢；发送的消息数量增加；药物治疗方案改变；以及更好的治疗依从性。
关于患者门户的现有对照研究数量较少。即使患者门户经常被作为一种增强患者能力和提高护理质量的方式进行讨论，但仍缺乏足够的证据支持这一假设。
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