Journal article
The impact of patient online access to computerized medical records and services on type 2 Diabetes: systematic review
- Abstract:
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BACKGROUND: Online access to computerized medical records has the potential to improve convenience, satisfaction, and care for patients, and to facilitate more efficient organization and delivery of care.
OBJECTIVE: The objective of this review is to explore the use and impact of having online access to computerized medical records and services for patients with type 2 diabetes mellitus in primary care.
METHODS: Multiple international databases including Medline, Embase, CINAHL, PsycINFO and the Cochrane Library were searched between 2004 and 2016. No limitations were placed on study design, though we applied detailed inclusion and exclusion criteria to each study. Thematic analysis was used to synthesize the evidence. The Mixed Methods Appraisal Toolkit was used to appraise study quality.
RESULTS: A search identified 917 studies, of which 28 were included. Five themes were identified: (1) disparities in uptake by age, gender, ethnicity, educational attainment, and number of comorbidities, with young men in full-time employment using these services most; (2) improved health outcomes: glycemic control was improved, but blood pressure results were mixed; (3) self-management support from improved self-care and shared management occurred especially soon after diagnosis and when complications emerged. There was a generally positive effect on physician-patient relationships; (4) accessibility: patients valued more convenient access when online access to computerized medical records and services work; and (5) technical challenges, barriers to use, and system features that impacted patient and physician use. The Mixed Methods Appraisal Toolkit rated 3 studies as 100%, 19 studies as 75%, 4 studies as 50%, and 1 study scored only 25%.
CONCLUSIONS: Patients valued online access to computerized medical records and services, although in its current state of development it may increase disparities. Online access to computerized medical records appears to be safe and is associated with improved glycemic control, but there was a lack of rigorous evidence in terms of positive health outcomes for other complications, such as blood pressure. Patients remain concerned about how these systems work, the rules, and timeliness of using these systems.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 359.2KB, Terms of use)
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- Publisher copy:
- 10.2196/jmir.7858
Authors
- Publisher:
- Journal of Medical Internet Research
- Journal:
- JMIR More from this journal
- Volume:
- 20
- Issue:
- 7
- Article number:
- e235
- Publication date:
- 2018-07-06
- Acceptance date:
- 2018-05-15
- DOI:
- EISSN:
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1438-8871
- ISSN:
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1439-4456
- Pmid:
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29980499
- Language:
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English
- Keywords:
- Pubs id:
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pubs:1013704
- UUID:
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uuid:ecd39885-ef31-4067-8a17-2849f8255c77
- Local pid:
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pubs:1013704
- Source identifiers:
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1013704
- Deposit date:
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2019-11-19
- ARK identifier:
Terms of use
- Copyright holder:
- Mold et al
- Copyright date:
- 2018
- Notes:
- © Freda Mold, Mary Raleigh, Nouf Sahal Alharbi, Simon de Lusignan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.07.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
- Licence:
- CC Attribution (CC BY)
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