Patient Accessible Electronic Health Records for the Chronically Ill: A Review of the Literature

Background: Consumers with chronic conditions account for approximately 70% of all healthcare spending. The Chronic Care Model is a healthcare paradigm whose purpose is the achievement of improved patient outcomes by facilitating the delivery of patient-centered, evidence-based care. We conducted a review of the literature to examine the role patient accessible electronic health records (PAEHR) may play in implementing and supporting the Chronic Care Model. Methods: A review of the literature was conducted using multiple databases (1950-2012). Publications included in the review were restricted to those using experimental or quasi-experimental methodology, English language and peer review. Results: Published results indicated that PAEHR facilitated improvements in health literacy and patient-provider communication, and that personalization of content was viewed favourably. Research on the use of PAEHR by some disease groups suggest improvements in clinical outcomes. Conclusions: The literature reviewed indicated that the patient experience for individuals with chronic illnesses could be enhanced through access to PAEHR. Improved satisfaction was noted for individuals with access to PAEHR with personalized content (e.g lab results etc). Use of PAEHR also improved patient-provider communication and increased personal knowledge and comprehension concerning individual condition and state of health. PAEHR for individuals living with chronic illnesses are an effective management technique that can help patients better manage the challenges of living with a chronic illness. These results indicate PAEHR have the potential to be a key component for actualizing the theoretical constructs of the Chronic Care Model by providing a platform for increased patient-provider collaboration.