scholarly journals Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review

10.2196/12779 ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. e12779 ◽  
Author(s):  
Ronald Dendere ◽  
Christine Slade ◽  
Andrew Burton-Jones ◽  
Clair Sullivan ◽  
Andrew Staib ◽  
...  
Keyword(s):  
Systematic Review ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Patient Portals

scholarly journals Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review (Preprint)

2018 ◽  
Author(s):  
Ronald Dendere ◽  
Christine Slade ◽  
Andrew Burton-Jones ◽  
Clair Sullivan ◽  
Andrew Staib ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Electronic Medical Records ◽  
Patient Engagement ◽  
Medical Records ◽  
Provider Communication ◽  
Patient Portals ◽  
High Quality ◽  
Patient Provider Communication

BACKGROUND Engaging patients in the delivery of health care has the potential to improve health outcomes and patient satisfaction. Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication. OBJECTIVE The aim of this study was to review literature describing patient portals tethered to an EMR in inpatient settings, their role in patient engagement, and their impact on health care delivery in order to identify factors and best practices for successful implementation of this technology and areas that require further research. METHODS A systematic search for articles in the PubMed, CINAHL, and Embase databases was conducted using keywords associated with patient engagement, electronic health records, and patient portals and their respective subject headings in each database. Articles for inclusion were evaluated for quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) for systematic review articles and the Quality Assessment Tool for Studies with Diverse Designs for empirical studies. Included studies were categorized by their focus on input factors (eg, portal design), process factors (eg, portal use), and output factors (eg, benefits) and by the valence of their findings regarding patient portals (ie, positive, negative, or mixed). RESULTS The systematic search identified 58 articles for inclusion. The inputs category was addressed by 40 articles, while the processes and outputs categories were addressed by 36 and 46 articles, respectively: 47 articles addressed multiple themes across the three categories, and 11 addressed only a single theme. Nineteen articles had high- to very high-quality, 21 had medium quality, and 18 had low- to very low-quality. Findings in the inputs category showed wide-ranging portal designs; patients’ privacy concerns and lack of encouragement from providers were among portal adoption barriers while information access and patient-provider communication were among facilitators. Several methods were used to train portal users with varying success. In the processes category, sociodemographic characteristics and medical conditions of patients were predictors of portal use; some patients wanted unlimited access to their EMRs, personalized health education, and nonclinical information; and patients were keen to use portals for communicating with their health care teams. In the outputs category, some but not all studies found patient portals improved patient engagement; patients perceived some portal functions as inadequate but others as useful; patients and staff thought portals may improve patient care but could cause anxiety in some patients; and portals improved patient safety, adherence to medications, and patient-provider communication but had no impact on objective health outcomes. CONCLUSIONS While the evidence is currently immature, patient portals have demonstrated benefit by enabling the discovery of medical errors, improving adherence to medications, and providing patient-provider communication, etc. High-quality studies are needed to fully understand, improve, and evaluate their impact.

Do Electronic Medical Records Improve Advance Directive Documentation? A Systematic Review

2018 ◽  
Vol 36 (3) ◽  
pp. 255-263 ◽  
Author(s):  
Christopher Lemon ◽  
Michael De Ridder ◽  
Mohamed Khadra
Keyword(s):  
Systematic Review ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Planning Process ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Decision Aids ◽  
Automatic Identification ◽  
Cross Sectional ◽  
Identification Software

Background: Documentation rates of advance directives (ADs) remain low. Using electronic medical records (EMRs) could help, but a synthesis of evidence is currently lacking. Objectives: To evaluate the evidence for using EMRs in documenting ADs and its implications for overcoming challenges associated with their use. Design: Systematic review of articles in English, published from inception of databases to December 2017. Data Sources: PubMed, PsycINFO, EMBASE, and CINAHL. Methods/Measurements: Four databases were searched from inception to December 2017. Randomized and nonrandomized quantitative studies examining the effects of EMRs on creation, storage, or use of ADs were included. All featured an advance care planning process. Evidence was evaluated using the Cochrane Collaboration’s risk assessment tool. Results: Fifteen studies were included: 1 randomized controlled trial, 1 randomized pilot, 4 pre–post studies, 4 cross-sectional studies, 1 retrospective cohort study, 1 historical control study, 1 retrospective observational study, 1 retrospective review, and 1 evaluation of an EMR feature. Seven studies showed that EMR-based reminders, AD templates, and decision aids can improve AD documentation rates. Three demonstrated that EMR search functions, decision aids, and automatic identification software can help identify patients who have or need ADs according to certain criteria. Five showed EMRs can create documentation challenges, including locating ADs, and making some patients more likely than others to have an AD. Most studies had an unclear or high risk of bias. Conclusions: Limited evidence suggests EMRs could be used to help address AD documentation challenges but may also create additional problems. Stronger evidence is needed to more conclusively determine how EMR may assist in population approaches to improving AD documentation.

Patient and family engagement in communicating with electronic medical records in hospitals: A systematic review

2020 ◽  
Vol 134 ◽  
pp. 104036
Author(s):  
Elizabeth Manias ◽  
Tracey Bucknall ◽  
Nilmini Wickramasinghe ◽  
Kathleen Gray ◽  
Jonathan Schaffer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Family Engagement

THE PREVALENCE OF PROBABLE FAMILIAL CHYLOMICRONEMIA SYNDROME IN A SOUTHERN CALIFORNIA POPULATION

2020 ◽  
Author(s):  
Mrinali Tripathi ◽  
April Wong ◽  
Victoria Solomon ◽  
Hussein N. Yassine
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Southern California ◽  
Genetic Disorder ◽  
Lipid Lowering ◽  
Inadequate Response ◽  
Academic Center ◽  
Secondary Causes

Background: Familial Chylomicronemia Syndrome (FCS) is a rare genetic disorder characterized by severe hypertriglyceridemia with inadequate response to lipid lowering agents or low-fat diet. The diagnosis of FCS is often missed due to the heterogeneity of its clinical features. Due to lack of awareness, most FCS cases are misdiagnosed or detected too late resulting in complications. Objective: Our goal is to estimate the prevalence of probable FCS in a major Southern California Academic Center, as well as to provide a systematic review of past FCS studies and management recommendations. Methods: Electronic medical records were queried based on a single fasting plasma triglyceride (TG) values of ≥ 880 mg/dL and at least one episode of acute pancreatitis. After exclusion of secondary causes (diabetes, alcohol use, gall bladder disease, chronic kidney disease, uncontrolled hypothyroidism, estrogen, drug use) and response to lipid lowering treatment, probable FCS patients were identified. A systematic review of all published literature on the prevalence and management guidelines for FCS was then presented and discussed. Results: Out of 7,699,288 charts queried, 138 patients with TG levels of ≥880 mg/dL and documented evidence of at least one episode of acute pancreatitis were identified. Nine patients did not have any documented secondary causes of chylomicronemia. Four of the 9 patients had a greater than 20% decrease in TG levels after lipid lowering treatment, 2 patients were not responsive to lipid lowering medication, and data on lipid lowering medications was missing in 3 patients. Conclusions: Our study estimates the prevalence of probable FCS at a range of 0.26 to 0.66 per million. Using the recommended above criteria, probable FCS cases can be identified to allow early diagnosis and management. Abbreviations: FCS = Familial Chylomicronemia Syndrome; MCS = Multifactorial Chylomicronemia Syndrome; CS = Chylomicronemia Syndrome; HTG = Hypertriglyceridemia; TG = Triglyceride; LPL = Lipoprotein Lipase; EMR = Electronic Medical Records.

Methods Employed to Assess Weight Loss in Older Adults by Means of Electronic Medical Records: A Systematic Review

2017 ◽  
Vol 36 (1) ◽  
pp. 18-30 ◽  
Author(s):  
Sunny Chen ◽  
William A. Banks ◽  
Julie Silverman ◽  
Meera Sheffrin ◽  
Stephen M. Thielke
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Weight Loss ◽  
Electronic Medical Records ◽  
Medical Records

scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

BACKGROUND The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. OBJECTIVE A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. METHODS Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. RESULTS Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. CONCLUSIONS The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

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