Freda Mold|Simon de Lusignan|Aziz Sheikh|Azeem Majeed|Jeremy Wyatt|Tom Quinn|Mary Cavill|C Pellicer Franco|Umesh Chauhan|Hannah Blakey|Neha Kataria|Theodoros N. Arvanitis|Beverley Suzanne Ellis
Patients’ online access to their electronic health records and linked online services: a systematic review in primary care
University of Surrey|University of Surrey|University of Edinburgh|Imperial College London|University of Leeds|University of Surrey|Royal College of General Practitioners|University of Dundee|University of Central Lancashire|University of Surrey|University of Warwick|University of Central Lancashire
online access medical records patients potentially enhance provision patientcentred care improve satisfaction however online access services may also prove additional burden healthcare providerto assess impact providing patients access general practice electronic health records ehr ehrlinked online services provision quality safety health carea systematic review conducted focused studies online record access transactional services primary caredata sources included medline embase cinahl cochrane library epoc dare kings fund nuffield health psycinfo opengrey 19992012 literature independently screened detailed inclusion exclusion criteria independent dual data extraction conducted risk bias rob assessed narrative synthesis evidence conducteda total 176 studies identified 17 randomised controlled trials cohort cluster studies patients reported improved satisfaction online access services compared standard provision improved selfcare better communication engagement clinicians safety improvements patientled identifying medication errors facilitating use preventive services provision online record access services resulted moderate increase email change telephone contact variable effects facetoface contact however tasks necessary sustain services impacted clinician time reports harm breaches privacywhile rob scores suggest many studies low quality patients using online services reported increased convenience satisfaction services positively impacted patient safety although variations record access use specific ethnic socioeconomic groups professional concerns privacy unrealised workload partly