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ACHI

OPENING MEDICAL RECORDS FOR PATIENTS A LIMITED LITERATURE REVIEW

Personal health records (PHRs) are the next big thing after electronic health records (EHRs), enabled by the uptake of electronic clinical notes and additional functionality. As part of the Australasian College of Health Informatics’ (ACHI) new biannual evidence review, we assessed 10 research articles on patient accessible records published in 2013 to see if a picture is emerging on the design and use of PHRs. DR KAREN DAY RN, PhD, FACHI DR CHRIS BAIN MBBS, Master Info Tech, MACS, FACHI

PHRs have begun to feature in health IT policy, such as the development of the PCEHR in Australia, and a New Zealand policy specifying that everyone will have access to the basics of their health information. What does this mean and how can we leverage PHRs to improve health outcomes? Is it safe for patients to use the functions, and what are some of the barriers to engaging in healthcare via PHRs? What is the potential for PHRs to improve access to care and how will services change? We have conducted a literature review of 10 articles about patient accessible records – a broader term to identify papers about PHRs, and the ‘state of accessibility’ – to assess the current state of play with PHR adoption. The articles were chosen from a broader group of articles suggested by ACHI members as being of particular importance or interest, as part of its newly instituted biannual evidence review1.

About the author Dr Karen Day is a senior lecturer in health informatics at the University of Auckland’s School of Population Health. Dr Chris Bain is a research fellow with the Faculty of IT at Monash University. They are members of ACHI’s program evaluation subcommittee (PES).

The objective of this process was not to produce a systematic review of the literature, but rather a contemporaneous snapshot of evidence around an issue – in this case the issue of patient accessible records – put forward by the members of a key relevant national professional body. The first step of our literature review was to invite ACHI Fellows to recommend articles for review for the year of 2013

on the topic of PHRs. There were 13 recommendations, and the authors also searched Medline, Google Scholar, PsychInfo and CINAHL databases to add to articles from the ACHI constituency to ensure good coverage on the topic. Articles were included if they presented research findings about patient accessible records (which were often PHRs) and/or patient portals. In total there were 33 articles, of which 10 were selected for more detailed analysis. Table 1 lists the selected articles. Once all the articles were identified for inclusion in the review process, we separately analysed the abstracts of candidate articles. We scored each abstract according to relevance to topic, academic rigour, novel or insightful nature of content, and real world applicability of findings or lessons. The scores were tallied and the 10 articles that scored highest were selected for full analysis and inclusion in this report. The draft report was reviewed by the members of the ACHI program evaluation subcommittee (PES) members and adjusted according to feedback received.

Findings The 10 articles reported on research in the USA and Australia. The three Australian articles by Lau and colleagues reported on two randomised controlled trials (RCTs) about how people used a ‘personally


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