Access to personal medical records (9) Systematic review: 'may provide little to no benefit'

2 June, 2021

On HIFA we have increasingly recognised that access to one's own personal medical records is an important part of the healthcare information that people need to protect their own health. This high-quality Cochrane systematic review finds, surprisingly and disappointingly, that 'Access to electronic health records (and extra services) may provide little to no benefit for patients' feelings of empowerment or satisfaction, nor for risk factors for diabetes, cardiovascular disease, and high pressure inside the eye (a risk factor for glaucoma). Such access may slightly increase how many patients keep up with monitoring for risk factors.'

The authors concede 'We are not confident in our results because of the small number of studies found. Our search may have missed some relevant studies because of differences in terms used for electronic health records. In addition, we identified limitations in the ways most studies were designed or conducted. Further evidence is likely to change our results.'

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

Below are the citation and (heavily edited) abstract. I would be interested to hear your views.

CITATION: Ammenwerth E, Neyer S, Hörbst A, Mueller G, Siebert U, Schnell-Inderst P. Adult patient access to electronic health records. Cochrane Database of Systematic Reviews. 2021;(2):Art. No.: CD012707. DOI: 10.1002/14651858.CD012707.pub2

ABSTRACT

BACKGROUND: To support patient-centred care, healthcare organisations increasingly offer patients access to data stored in the institutional electronic health record (EHR).

OBJECTIVES: PRIMARY OBJECTIVE: 1. To assess the effects of providing adult patients with access to electronic health records (EHRs) alone or with additional functionalities on a range of patient, patient-provider, and health resource consumption outcomes, including patient knowledge and understanding, patient empowerment, patient adherence, patient satisfaction with care, adverse events, health-related quality of life, health-related outcomes, psychosocial health outcomes, health resource consumption, and patient-provider communication. SECONDARY OBJECTIVE: 1. To assess whether effects of providing adult patients with EHR access alone versus EHR access with additional functionalities differ among patient groups according to age, educational level, or different status of disease (chronic or acute)...

MAIN RESULTS: [...] Overall, results suggest that the effects of EHR access alone and with additional functionalities are mostly uncertain when compared with usual care...

AUTHORS' CONCLUSIONS: The effects of EHR access with additional functionalities in comparison with usual care for the most part are uncertain. Only adherence to the process of monitoring risk factors and providing preventive services as well as a composite score of risk factors for diabetes mellitus may improve slightly with EHR access with additional functionalities...

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Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org