Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jan 1, 2020
Open Peer Review Period: Dec 31, 2019 - Feb 25, 2020
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How the use of a patient-accessible health records contributes to patient-centered care: Scoping Review.
Although worldwide implementation of patient accessible health records (PAEHR) as an instrument in patient-centered care (PC) is expanding, its advantages and disadvantages do not seem to be structurally evaluated to date.
The objective is to review whether and how the use of a PAEHR contributes to PC both in general and among specific patient groups.
Adapted PRISMA reporting guidelines for scoping reviews were followed. Literature was identified in five databases, using the terms ‘patient-accessible medical records’, ‘patient experiences’ and ‘professional experiences’ as key concepts. A total of 49 articles were included and analyzed with a charting code list containing 10 elements of PC.
Studies were diverse in design, country of origin, functionalities of the investigated PAEHR and target population. Respondents in all studies were adults. The effect of PAEHRs on PC was evaluated as moderately positive: patient accessible health records were appreciated for their opportunity to empower patients, to inform them about their health, and to involve them in their own care. There were mixed results for the extent to which PAEHR affected the relation between patients and clinicians. Professionals and patients in mental healthcare held opposing views concerning the impact of transparency, professionals appearing more worried about potential negative impact. Their worries seemed to be influenced by a reluctant attitude toward PC. Disadvantaged groups appeared to have less access to and make less use of patient-accessible records than the average population, but experienced more benefits than the average population when they actually used a PAEHR.
The review indicated that PAEHRs bear potential to contribute to patient-centered care. However, concerns from professionals about the impact of transparency on the therapeutic relationship as well as the importance of a patient-centered attitude need to be addressed. Potentially high benefits for disadvantaged groups will be achieved only through easy-accessible and user-friendly PAEHRs. Ultimately, future research needs to address the question how PAEHRs affect PC among youths.
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