BACKGROUND
Worldwide, patient-centered care (PCC) is becoming a widely used concept in medical practice, getting more and more attention because of its proven ability to improve quality of care and reduce costs. Although several studies show that patient-accessible electronic health records (PAEHR) influence certain aspects of PCC, the possible contribution of PAEHR implementation to PCC as a comprehensive concept does not seem to be structurally evaluated to date.
OBJECTIVE
The objective is to review whether and how the use of a PAEHR contributes to PCC both in general and among specific population groups.
METHODS
PRISMA-Scr 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 PCC.
RESULTS
Studies were diverse in design, country of origin, functionalities of the investigated PAEHR and target population. Participants in all studies were adults. Most studies reported positive influence of PAEHR use on PCC: 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 on the patient-clinician relationship. Their worries seemed to be influenced by a reluctant attitude toward PCC.
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.
CONCLUSIONS
The review indicates that PAEHRs bear potential to positively contribute to PCC. However, concerns from professionals about the impact of transparency on the patient-clinician 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.
CLINICALTRIAL
None
Improving personal health records for patient-centered care