Evidence map›Paper›PMID 29681044›Full record

ArticleYearbook of medical informatics2018

Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group.

Harshana Liyanage, Siaw-Teng Liaw, Emmanouela Konstantara, Freda Mold, Richard Schreiber, Craig Kuziemsky, Amanda L Terry, Simon de Lusignan

Abstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Yearbook of medical informatics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Adult patient access to electronic health records.The Cochrane database of systematic reviews · 2021
    Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Harshana LiyanageDepartment of Clinical & Experimental Medicine, University of Surrey, GUILDFORD, Surrey, UK.
Siaw-Teng LiawSchool of Public Health & Community Medicine, UNSW Medicine Australia, Ingham Institute of Applied Medical Research, NSW, Australia.
Emmanouela KonstantaraDepartment of Clinical & Experimental Medicine, University of Surrey, GUILDFORD, Surrey, UK.
Freda MoldDepartment of Health and Medical Sciences, University of Surrey, GUILDFORD, Surrey GU2 7TE, UK.
Richard SchreiberGeisinger Holy Spirit, Camp Hill, PA, USA.
Craig KuziemskyTelfer School of Management, University of Ottawa, Ottawa, Ontario, Canada, K1N 6N5.
Amanda L TerryCentre for Studies in Family Medicine, Department of Family Medicine, Interfaculty Program in Public Health, Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Simon de LusignanDepartment of Clinical & Experimental Medicine, University of Surrey, GUILDFORD, Surrey, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs.

objectiveTo conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM).

methodA five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements.

resultsThirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements.

conclusionPatients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.

Indexed as

Attitude of Health PersonnelElectronic Health RecordsPatient Access to RecordsAdultConfidentialityDelphi TechniqueHealth PersonnelHumansInternetMedical InformaticsMedical Records Systems, ComputerizedSocieties, MedicalSurveys and Questionnaires

Identifiers

PMID29681044
PMCPMC6115222

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.