Neves Ana Luisa, Carter Alexander W, Freise Lisa, Laranjo Liliana, Darzi Ara, Mayer Erik K
Center for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK.
CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal.
BMJ Open. 2018 Aug 13;8(8):e020387. doi: 10.1136/bmjopen-2017-020387.
Providing patients with access to electronic health records (EHRs) has emerged as a promising solution to improve quality of care and safety. As the efforts to develop and implement EHR-based data sharing platforms mature and scale up worldwide, there is a need to evaluate the impact of these interventions and to weigh their relative risks and benefits, in order to inform evidence-based health policies. The aim of this work is to systematically characterise and appraise the demonstrated benefits and risks of sharing EHR with patients, by mapping them across the six domains of quality of care of the Institute of Medicine (IOM) analytical framework (ie, patient-centredness, effectiveness, efficiency, timeliness, equity and safety).
CINAHL, Cochrane, Embase, HMIC, Medline/PubMed and PsycINFO databases will be searched from January 1997 to August 2017. Primary outcomes will include measures related with the six domains of quality of care of the IOM analytical framework. The quality of the studies will be assessed using the Cochrane Risk of Bias Tool, the ROBINS-I Tool and the Drummond's checklist. A narrative synthesis will be conducted for all included studies. Subgroup analysis will be performed by domain of quality of care domain and by time scale (ie, short-term, medium-term or long-term impact). The body of evidence will be summarised in a Summary of Findings table and its strength assessed according to the GRADE criteria.
This review does not require ethical approval as it will summarise published studies with non-identifiable data. This protocol complies with the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols guidelines. Findings will be disseminated widely through peer-reviewed publication and conference presentations, and patient partners will be included in summarising the research findings into lay summaries and reports.
CRD42017070092.
为患者提供电子健康记录（EHR）访问权限已成为改善医疗质量和安全性的一个有前景的解决方案。随着全球范围内开发和实施基于EHR的数据共享平台的努力不断成熟并扩大规模，有必要评估这些干预措施的影响，并权衡其相对风险和益处，以便为循证卫生政策提供依据。这项工作的目的是通过将与患者共享EHR的已证明的益处和风险映射到医学研究所（IOM）分析框架的六个医疗质量领域（即以患者为中心、有效性、效率、及时性、公平性和安全性），系统地描述和评估这些益处和风险。
将检索1997年1月至2017年8月的CINAHL、Cochrane、Embase、HMIC、Medline/PubMed和PsycINFO数据库。主要结局将包括与IOM分析框架的六个医疗质量领域相关的指标。将使用Cochrane偏倚风险工具、ROBINS-I工具和Drummond清单评估研究质量。将对所有纳入研究进行叙述性综合分析。将按医疗质量领域和时间尺度（即短期、中期或长期影响）进行亚组分析。证据将在结果总结表中进行总结，并根据GRADE标准评估其强度。
本综述不需要伦理批准，因为它将总结已发表的、数据不可识别的研究。本方案符合系统评价和Meta分析方案的首选报告项目指南。研究结果将通过同行评审出版物和会议报告广泛传播，患者合作伙伴将参与将研究结果总结为通俗易懂的摘要和报告。
PROSPERO注册号：CRD42017070092。
