Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study

BackgroundPatient access to electronic health records (EHRs) is associated with increased patient engagement and health care quality outcomes. However, the adoption of patient portals and personal health records (PHRs) that facilitate this access is impeded by barriers. The Clinical Adoption Framewo...

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Main Authors: van Mens, Hugo J T, Duijm, Ruben D, Nienhuis, Remko, de Keizer, Nicolette F, Cornet, Ronald
Format: Article
Language:English
Published: JMIR Publications 2020-03-01
Series:JMIR Medical Informatics
Online Access:http://medinform.jmir.org/2020/3/e15150/
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author van Mens, Hugo J T
Duijm, Ruben D
Nienhuis, Remko
de Keizer, Nicolette F
Cornet, Ronald
author_facet van Mens, Hugo J T
Duijm, Ruben D
Nienhuis, Remko
de Keizer, Nicolette F
Cornet, Ronald
author_sort van Mens, Hugo J T
collection DOAJ
description BackgroundPatient access to electronic health records (EHRs) is associated with increased patient engagement and health care quality outcomes. However, the adoption of patient portals and personal health records (PHRs) that facilitate this access is impeded by barriers. The Clinical Adoption Framework (CAF) has been developed to analyze EHR adoption, but this framework does not consider the patient as an end-user. ObjectiveWe aim to extend the scope of the CAF to patient access to EHRs, develop guidance documentation for the application of the CAF, and assess the interrater reliability. MethodsWe systematically reviewed existing systematic reviews on patients' access to EHRs and PHRs. Results of each review were mapped to one of the 43 CAF categories. Categories were iteratively adapted when needed. We measured the interrater reliability with Cohen’s unweighted kappa and statistics regarding the agreement among reviewers on mapping quotes of the reviews to different CAF categories. ResultsWe further defined the framework’s inclusion and exclusion criteria for 33 of the 43 CAF categories and achieved a moderate agreement among the raters, which varied between categories. ConclusionsIn the reviews, categories about people, organization, system quality, system use, and the net benefits of system use were addressed more often than those about international and regional information and communication technology infrastructures, standards, politics, incentive programs, and social trends. Categories that were addressed less might have been underdefined in this study. The guidance documentation we developed can be applied to systematic literature reviews and implementation studies, patient and informal caregiver access to EHRs, and the adoption of PHRs.
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spelling doaj.art-d74ea76bd0354c3fb147d3b3a3d43a122022-12-21T20:17:15ZengJMIR PublicationsJMIR Medical Informatics2291-96942020-03-0183e1515010.2196/15150Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Studyvan Mens, Hugo J TDuijm, Ruben DNienhuis, Remkode Keizer, Nicolette FCornet, RonaldBackgroundPatient access to electronic health records (EHRs) is associated with increased patient engagement and health care quality outcomes. However, the adoption of patient portals and personal health records (PHRs) that facilitate this access is impeded by barriers. The Clinical Adoption Framework (CAF) has been developed to analyze EHR adoption, but this framework does not consider the patient as an end-user. ObjectiveWe aim to extend the scope of the CAF to patient access to EHRs, develop guidance documentation for the application of the CAF, and assess the interrater reliability. MethodsWe systematically reviewed existing systematic reviews on patients' access to EHRs and PHRs. Results of each review were mapped to one of the 43 CAF categories. Categories were iteratively adapted when needed. We measured the interrater reliability with Cohen’s unweighted kappa and statistics regarding the agreement among reviewers on mapping quotes of the reviews to different CAF categories. ResultsWe further defined the framework’s inclusion and exclusion criteria for 33 of the 43 CAF categories and achieved a moderate agreement among the raters, which varied between categories. ConclusionsIn the reviews, categories about people, organization, system quality, system use, and the net benefits of system use were addressed more often than those about international and regional information and communication technology infrastructures, standards, politics, incentive programs, and social trends. Categories that were addressed less might have been underdefined in this study. The guidance documentation we developed can be applied to systematic literature reviews and implementation studies, patient and informal caregiver access to EHRs, and the adoption of PHRs.http://medinform.jmir.org/2020/3/e15150/
spellingShingle van Mens, Hugo J T
Duijm, Ruben D
Nienhuis, Remko
de Keizer, Nicolette F
Cornet, Ronald
Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study
JMIR Medical Informatics
title Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study
title_full Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study
title_fullStr Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study
title_full_unstemmed Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study
title_short Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study
title_sort towards an adoption framework for patient access to electronic health records systematic literature mapping study
url http://medinform.jmir.org/2020/3/e15150/
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