Access to personal medical records (16) Systematic review: 'may provide little to no benefit' (6)

5 June, 2021

Hi Najeeb,

I was forwarded your e-mail by Richard Fitton [https://www.hifa.org/dgroups-rss/access-personal-medical-records-10-syst.... I’m not sure which systematic review you refer to – it may be one of the most recent ones by Ammenwerth et al: [*see note below]

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012707.pub2/...

or one published a year earlier by Neves et al:

https://qualitysafety.bmj.com/content/29/12/1019

Both reviews do report quite a few studies showing a significant positive effect of online records access.

The Neves et al review conducted a meta-analysis which found a significant effect on HbA1c, although Ammenwerth felt there was too much heterogeneity to conduct a meta-analysis. Ammenwerth also notes that the evidence is mostly too low quality to draw firm conclusions – but a lack of evidence is not the same as evidence against.

Part of the problem, in my opinion is that what is meant by online records access varies hugely between: studies, systems, countries, individuals, etc. In the UK, 2 patients asking their GP surgery for online records access may end up with different levels of access – one person might be able to see their entire record, whilst another might only be able to book appointments and order repeat prescriptions. In the UK, it is very difficult to find out who can see what, because there are so many different systems providing online access, and doing it in different ways. I have tried to get this data without any success.

A systematic review examining if online records access improves health outcomes and care feels similar (to me) as a systematic review examining if a healthy diet reduces cancer risk. Just as a ‘healthy diet’ is too vague t really be very meaningful, so I feel is ‘online records access’. I feel we need to get much more specific about both the intervention and the outcomes.

Regards,

Brian

Dr Brian McMillan | NIHR Advanced Fellow | Centre for Primary Care and Health Services Research | Suite 3, Floor 6, Williamson Building | University of Manchester | Oxford Road | Manchester, M13 9PL | Web: http://tinyurl.com/brwmcmillan<http://tinyurl.com/hjl5f3b

HIFA profile: Brian McMillan is a GP and NIHR Advanced Fellow at the University of Manchester, United Kingdom. Professional interests: I'm an NIHR Advanced Fellow at the Centre for

Primary Care and Health Services Research, a practising GP and a Registered Health Psychologist. My research interests include the application of digital technology and psychological theory to improving patients' experiences of primary care. Email address: brian.mcmillan AT manchester.ac.uk

[*Note from HIFA moderator (Neil PW): Najeeb refers to the recent systematic review by recent ones by Ammenwerth et al]