Department of Strategic ICT, Helse Vest IKT, Bergen, Norway; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
Department of Strategic ICT, Helse Vest IKT, Bergen, Norway; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
Int J Med Inform. 2025 Jan;193:105688. doi: 10.1016/j.ijmedinf.2024.105688. Epub 2024 Nov 1.
Cross-organizational access to shared electronic health records can enhance integrated, people-centered health services. However, a gap remains between these potential benefits and the limited support currently offered by electronic health records. The Valkyrie research project aims to bridge this gap by developing a technical prototype of an architecture to promote healthcare service coordination.
To inform the Valkyrie project, we aimed to evaluate approaches for healthcare professionals' access to electronic health records across healthcare providers and identify factors influencing the success and failure of these approaches.
Using the Joanna Briggs Institute guidance for scoping reviews, searches were conducted in six research databases and grey literature, without limitations on year or language. Papers selected for full-text review were analyzed, and data was extracted using standardized forms that reflected the population, concept, and context framework and the categorization model used in the qualitative analysis of the barriers and facilitators reported in the included papers.
Among the 290 identified papers, five were deemed eligible for full-text review. The included papers were heterogeneous in country, year of publication, study setting, implementation level, and access approaches to electronic health records, highlighting various techniques, from federated to centralized, for accessing shared electronic health records.
The review did not identify one single superior access approach. However, a hybrid approach incorporating components from the different approaches combined with emerging technologies may benefit the Valkyrie project. The key facilitators were identified as improved information quality and flexible and easy access. In contrast, lack of trust and poor information quality were significant barriers to successful cross-organizational access to electronic health records. Future research should explore alternative access approaches, considering information quality, user training, and collegial trust across healthcare providers.
跨组织访问共享电子健康记录可以增强以人为中心的综合医疗服务。然而，这些潜在的好处与电子健康记录目前提供的有限支持之间仍然存在差距。Valkyrie 研究项目旨在通过开发一种促进医疗服务协调的架构技术原型来弥合这一差距。
为了为 Valkyrie 项目提供信息，我们旨在评估医疗保健专业人员跨医疗服务提供者访问电子健康记录的方法，并确定影响这些方法成功与失败的因素。
使用 Joanna Briggs 研究所的范围综述指南，在六个研究数据库和灰色文献中进行了搜索，没有对年份或语言进行限制。选择进行全文审查的论文进行了分析，并使用反映人口、概念和背景框架以及纳入论文中报告的障碍和促进因素的定性分析中使用的分类模型的标准化表格提取数据。
在 290 篇确定的论文中，有 5 篇被认为有资格进行全文审查。纳入的论文在国家、发表年份、研究设置、实施级别和访问电子健康记录的方法方面存在差异，突出了从联合到集中的各种技术，用于访问共享电子健康记录。
该综述没有确定一种单一的优越访问方法。然而，一种混合方法，结合不同方法的组件，并结合新兴技术，可能会使 Valkyrie 项目受益。主要的促进因素是信息质量的提高以及灵活和方便的访问。相比之下，缺乏信任和信息质量差是成功跨组织访问电子健康记录的重大障碍。未来的研究应探索替代访问方法，同时考虑信息质量、用户培训和跨医疗服务提供者的同事信任。
