Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science System, The University of Manchester, Manchester, United Kingdom.
Nuclear Medicine Department, Faisal Sultan Bin Eissa, Kuwait Cancer Control Center, Kuwait City, Kuwait.
J Med Internet Res. 2024 Nov 20;26:e56473. doi: 10.2196/56473.
Health information technologies, including electronic health records (EHRs), have revolutionized health care delivery. These technologies promise to enhance the efficiency and quality of care through improved patient health information management. Despite the transformative potential of EHRs, the extent to which patient access contributes to increased engagement with health care services within different clinical setting remains a distinct and underexplored facet.
This systematic review aims to investigate the impact of patient access to EHRs on health care engagement. Specifically, we seek to determine whether providing patients with access to their EHRs contributes to improved engagement with health care services.
A comprehensive systematic review search was conducted across various international databases, including Ovid MEDLINE, Embase, PsycINFO, and CINAHL, to identify relevant studies published from January 1, 2010, to November 15, 2023. The search on these databases was conducted using a combination of keywords and Medical Subject Heading terms related to patient access to electronic health records, patient engagement, and health care services. Studies were included if they assessed the impact of patient access to EHRs on health care engagement and provided evidence (quantitative or qualitative) for that. The guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement were followed for study selection, data extraction, and quality assessment. The included studies were assessed for quality using the Mixed Methods Appraisal Tool, and the results were reported using a narrative synthesis.
The initial search from the databases yielded 1737 studies, to which, after scanning their reference lists, we added 10 studies. Of these 1747 studies, 18 (1.03%) met the inclusion criteria for the final review. The synthesized evidence from these studies revealed a positive relationship between patient access to EHRs and health care engagement, addressing 6 categories of health care engagement dimensions and outcomes, including treatment adherence and self-management, patient involvement and empowerment, health care communication and relationship, patient satisfaction and health outcomes, use of health care resources, and usability concerns and barriers.
The findings suggested a positive association between patient access to EHRs and health care engagement. The implications of these findings for health care providers, policy makers, and patients should be considered, highlighting the potential benefits and challenges associated with implementing and promoting patient access to EHRs. Further research directions have been proposed to deepen our understanding of this dynamic relationship.
健康信息技术，包括电子健康记录 (EHR)，已经彻底改变了医疗保健的提供方式。这些技术有望通过改善患者健康信息管理来提高医疗服务的效率和质量。尽管 EHR 具有变革性的潜力，但患者访问在不同临床环境中增加医疗服务参与度的程度仍然是一个独特且尚未充分探索的方面。
本系统评价旨在研究患者访问 EHR 对医疗服务参与度的影响。具体而言，我们旨在确定为患者提供访问 EHR 是否有助于提高对医疗服务的参与度。
对包括 Ovid MEDLINE、Embase、PsycINFO 和 CINAHL 在内的多个国际数据库进行了全面的系统检索，以确定自 2010 年 1 月 1 日至 2023 年 11 月 15 日期间发表的相关研究。这些数据库上的搜索使用了与患者访问电子健康记录、患者参与度和医疗服务相关的关键词和医学主题词的组合。如果研究评估了患者访问 EHR 对医疗服务参与度的影响，并提供了相关证据（定量或定性），则将其纳入研究。研究选择、数据提取和质量评估均遵循 PRISMA（系统评价和荟萃分析的首选报告项目）2020 声明的指南。使用混合方法评估工具对纳入的研究进行质量评估，并使用叙述性综合报告结果。
数据库中的初步搜索产生了 1737 项研究，在扫描其参考文献后，我们又添加了 10 项研究。在这 1747 项研究中，有 18 项（1.03%）符合最终综述的纳入标准。对这些研究的综合证据表明，患者访问 EHR 与医疗服务参与度之间存在正相关关系，涉及医疗服务参与度的 6 个维度和结果，包括治疗依从性和自我管理、患者参与和赋权、医疗保健沟通和关系、患者满意度和健康结果、医疗保健资源的使用以及可用性问题和障碍。
研究结果表明患者访问 EHR 与医疗服务参与度之间存在正相关关系。这些发现对医疗保健提供者、政策制定者和患者具有重要意义，突出了实施和推广患者访问 EHR 所带来的潜在益处和挑战。已经提出了进一步的研究方向，以深化我们对这一动态关系的理解。
