JMIR Publications

ABSTRACT

Background:

Health information technologies (HITs), including electronic health records (EHRs), have revolutionized healthcare delivery. These technologies promise to enhance the efficiency and quality of care through improved patient health information management. Despite the transformative potential of EHRs, the extent to which patient access contributes to increased engagement with healthcare services within different clinical setting remains a distinct and underexplored facet.

Objective:

This systematic review aims to investigate the influence of patient access to EHRs on healthcare engagement. Specifically, we seek to determine whether providing patients with access to their EHRs contributes to improved engagement with healthcare services.

Methods:

A comprehensive systematic review search was conducted across various international databases, including Ovid MEDLINE, Embase, PsycINFO, and CINAHL, to identify relevant studies published from January 1, 2010 up to 15 November, 2023. The search on these databases was conducted using a combination of keywords and MeSH terms related to "patient access to electronic health records", "patient engagement", and "healthcare services". Studies were included if they assessed the impact of patient access to EHRs on healthcare engagement and provided evidence (quantitative or qualitative evidence) for that. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement were followed for study selection, data extraction, and quality assessment. Included studies were assessed for quality using a Mixed Methods Appraisal Tool (MMAT), and the results were reported using the narrative synthesis.

Results:

The initial search from the databases yielded 1737 studies, that were supported with 10 additional studies identified from scanning their reference lists. Of which, 18 met the inclusion criteria for the final review. The synthesized evidence from these studies revealed a positive relationship between patient access to EHRs and healthcare engagement, addressing various 6 categories of healthcare engagement dimensions/outcomes, including treatment adherence and self-management; patient involvement and empowerment; healthcare communication and relationship; patient satisfaction and health outcomes; utilization of healthcare resources; and usability concerns and barriers.

Conclusions:

The findings suggested a positive association between patient access to EHRs and healthcare engagement. The implications of these findings for healthcare providers (HCPs), policymakers, and patients should be considered, highlighting the potential benefits and challenges associated with implementing and promoting patient access to EHRs. Further research directions have been proposed to deepen our understanding of this dynamic relationship.