Svendsen Mathias T, Tiedemann Sylvia N, Andersen Klaus Ejner
Department of Clinical Research, University of Southern Denmark, Odense M, Denmark.
Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
SAGE Open Med. 2021 May 18;9:20503121211016179. doi: 10.1177/20503121211016179. eCollection 2021.
The main objectives of this article are to systematically review the recent literature on patient safety in relation to the use of eHealth and to investigate how the Danish authorities supervise private eHealth clinics with regard to patient safety.
Original studies reporting the association between patient safety and the use of eHealth as a means of communication between patients and healthcare providers were included. Four literature databases were searched for English-language articles reporting results from cohort studies and clinical trials, published from 2015 until March 2021. Moreover, registered private eHealth clinics in Denmark were evaluated with reference to a recent national audit of patient safety issues in eHealth.
The literature search retrieved four intervention studies. The studies did not identify any particular patient safety risks associated with the use of eHealth. Many different authorized healthcare providers (preferably, doctors) apply eHealth in various contexts. eHealth is being used as the only form of contact between the healthcare provider and the patient, as a supplement to patient visitations in an outpatient clinic, or as a tool for communicating between two or more healthcare providers. The regulation of eHealth involves patient safety issues but also has interfaces to marketing, IT systems, and infrastructure. Supervision of eHealth includes the organization of clinics, handling patient charts, prescription medicine, patient legal rights, and patient transition. However, there are many interfaces in the division of responsibilities among the various governmental players.
eHealth is being used increasingly and in many settings, although recently published intervention studies investigating patient safety issues by the use of eHealth are limited. A structured and continuous governmental control and regulation of patient safety in relation to the use of eHealth is warranted.
本文的主要目的是系统回顾近期关于电子健康（eHealth）使用与患者安全相关的文献，并调查丹麦当局如何监督私立电子健康诊所的患者安全情况。
纳入报告患者安全与使用电子健康作为患者与医疗服务提供者之间沟通手段之间关联的原创性研究。检索了四个文献数据库，查找2015年至2021年3月发表的报道队列研究和临床试验结果的英文文章。此外，参照近期对电子健康患者安全问题的全国性审计，对丹麦注册的私立电子健康诊所进行了评估。
文献检索找到四项干预研究。这些研究未发现与使用电子健康相关的任何特定患者安全风险。许多不同的授权医疗服务提供者（最好是医生）在各种情况下使用电子健康。电子健康被用作医疗服务提供者与患者之间的唯一联系方式、门诊患者就诊的补充方式，或两个或多个医疗服务提供者之间沟通的工具。电子健康的监管涉及患者安全问题，但也与营销、信息技术系统和基础设施存在交叉。对电子健康的监督包括诊所的组织、患者病历处理、处方药、患者合法权利以及患者转诊。然而，在各政府部门之间的职责划分上存在许多交叉点。
尽管近期发表的通过使用电子健康调查患者安全问题的干预研究有限，但电子健康在越来越多的场景中得到使用。有必要对与电子健康使用相关的患者安全进行结构化且持续的政府管控和监管。
