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Showell C. Barriers to the use of personal health records by patients: a structured review. PeerJ. 2017;5:e3268doi: 10.7717/peerj.3268.
Showell, C. (2017). Barriers to the use of personal health records by patients: a structured review. PeerJ, 5e3268. https://doi.org/10.7717/peerj.3268
Showell, Chris. "Barriers to the use of personal health records by patients: a structured review." PeerJ vol. 5 (2017): e3268. doi: https://doi.org/10.7717/peerj.3268
Showell C. Barriers to the use of personal health records by patients: a structured review. PeerJ. 2017 Apr 27;5:e3268. doi: 10.7717/peerj.3268. eCollection 2017. PMID: 28462058; PMCID: PMC5410160.
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PeerJ. 2017 Apr 27;5:e3268. doi: 10.7717/peerj.3268. eCollection 2017.

Barriers to the use of personal health records by patients: a structured review.

PeerJ

Chris Showell

Affiliations

  1. eHealth Services Research Group, University of Tasmania, Australia.

PMID: 28462058 PMCID: PMC5410160 DOI: 10.7717/peerj.3268

Abstract

INTRODUCTION: An increasing focus on personal electronic health records (PHRs) offers healthcare benefits for patients, particularly those in undeserved and marginalised populations, who are at risk of receiving less effective healthcare, and may have worse health outcomes. However, PHRs are likely to favour text, technical and health literate users, and be less suitable for disadvantaged patients. These concerns have prompted this review of the literature, which seeks evidence about barriers to the adoption and continued use of PHRs, the nature of the evidence for those barriers, and the stage of PHR implementation where particular barriers apply.

METHODS: Searches in PubMed, Embase, CINAHL and ProQuest databases were used to retrieve articles published in English after 2003 in a refereed journal, or presented in a refereed conference or scientific meeting. After screening to remove items which were out of scope, the phase of the PHR implementation, the type of investigation, and PHR barriers were categorised using thematic coding.

RESULTS: The search retrieved 395 items; screening identified 34 in-scope publications, which provided evidence of 21 identified barriers to patient adoption and continued use of PHRs, categorised here as Individual, Demographic, Capability, Health-related, PHR or Attitudinal factors. Barriers were identified in most phases of PHR implementation, and in most types of study. A secondary outcome identified that eleven of the publications may have introduced a bias by excluding participants who were less affluent, less capable, or marginalised.

CONCLUSIONS: PHR barriers can interfere with the decision to start using a PHR, with the adoption process, and with continued use, and the impact of particular barriers may vary at different phases of PHR adoption. The complex interrelationships which exist between many of the barriers is suggested in some publications, and emerges more clearly from this review. Many PHR barriers appear to be related to low socioeconomic status. A better understanding is needed of how the effect of barriers is manifested, how that effect can be countered, and how planning and implementation of PHR initiatives can make allowance for patient level barriers to PHR adoption and use, with appropriate actions to mitigate the effect of those barriers for more disadvantaged patients.

Keywords: Barriers; Bias; Disadvantage; Personal health records; Structured review; eHealth

Conflict of interest statement

The author declares there are no competing interests.

References

  1. Health Aff (Millwood). 2002 Mar-Apr;21(2):60-76 - PubMed
  2. J Am Med Inform Assoc. 2005 Mar-Apr;12(2):113-20 - PubMed
  3. Health Aff (Millwood). 2005 Sep-Oct;24(5):1205-13 - PubMed
  4. Health Aff (Millwood). 2005 Sep-Oct;24(5):1290-5 - PubMed
  5. J Med Internet Res. 2005 Aug 05;7(4):e47 - PubMed
  6. AMIA Annu Symp Proc. 2005;:16-20 - PubMed
  7. AMIA Annu Symp Proc. 2006;:514-8 - PubMed
  8. BMJ. 2007 Aug 18;335(7615):330-3 - PubMed
  9. BMJ. 2008 Jun 7;336(7656):1290-5 - PubMed
  10. JAMA. 2008 Jun 25;299(24):2857-67 - PubMed
  11. J Gen Intern Med. 2009 Mar;24(3):349-55 - PubMed
  12. J Med Internet Res. 2009 Apr 29;11(2):e14 - PubMed
  13. J Am Med Inform Assoc. 2009 Sep-Oct;16(5):683-9 - PubMed
  14. PLoS Med. 2009 Jul 21;6(7):e1000100 - PubMed
  15. J Med Internet Res. 2009 Oct 27;11(4):e44 - PubMed
  16. Cardiol Young. 2010 Oct;20(5):477-84 - PubMed
  17. Stud Health Technol Inform. 2010;155:55-61 - PubMed
  18. Stud Health Technol Inform. 2010;156:128-37 - PubMed
  19. Telemed J E Health. 2010 Jun;16(5):595-602 - PubMed
  20. J Med Libr Assoc. 2010 Jul;98(3):243-9 - PubMed
  21. J Med Syst. 2012 Jun;36(3):1043-52 - PubMed
  22. J Health Commun. 2010;15 Suppl 2:183-96 - PubMed
  23. BMJ. 2010 Nov 16;341:c5814 - PubMed
  24. J Am Med Inform Assoc. 2011 May 1;18(3):318-21 - PubMed
  25. Stud Health Technol Inform. 2011;164:280-5 - PubMed
  26. Arch Intern Med. 2011 Mar 28;171(6):568-74 - PubMed
  27. Arch Pediatr Adolesc Med. 2011 May;165(5):405-11 - PubMed
  28. J Gen Intern Med. 2011 Oct;26(10):1112-6 - PubMed
  29. J Am Med Inform Assoc. 2012 Jan-Feb;19(1):128-33 - PubMed
  30. Gerontology. 2012;58(2):164-70 - PubMed
  31. Am J Manag Care. 2011 Apr;17(4):e104-20 - PubMed
  32. J Med Syst. 2012 Oct;36(5):3019-27 - PubMed
  33. J Med Internet Res. 2011 Sep 30;13(3):e71 - PubMed
  34. Appl Clin Inform. 2011;2(4):406-419 - PubMed
  35. J Am Med Inform Assoc. 2011 Dec;18 Suppl 1:i8-12 - PubMed
  36. PLoS One. 2012;7(2):e31888 - PubMed
  37. PLoS Med. 2012;9(5):e1001211 - PubMed
  38. Aust Health Rev. 2012 May;36(2):125-9 - PubMed
  39. Int J Med Inform. 2012 Oct;81(10):e63-73 - PubMed
  40. Health Aff (Millwood). 2012 Aug;31(8):1803-13 - PubMed
  41. Fam Med. 2012 May;44(5):342-7 - PubMed
  42. J Med Internet Res. 2012 Nov 05;14(6):e150 - PubMed
  43. Perspect Health Inf Manag. 2012;9:1-13 - PubMed
  44. Stud Health Technol Inform. 2013;183:276-80 - PubMed
  45. ABNF J. 2013 Winter;24(1):10-6 - PubMed
  46. JMIR Res Protoc. 2013 Jan 22;2(1):e8 - PubMed
  47. Inform Prim Care. 2012;20(3):151-69 - PubMed
  48. Stud Health Technol Inform. 2013;192:1037 - PubMed
  49. J Med Internet Res. 2013 Aug 26;15(8):e168 - PubMed
  50. J Am Med Inform Assoc. 2014 Jul-Aug;21(4):679-86 - PubMed
  51. Diabetes Care. 2014;37(1):e13-4 - PubMed
  52. Psychol Aging. 2013 Dec;28(4):1124-39 - PubMed
  53. AMIA Annu Symp Proc. 2013 Nov 16;2013:152-61 - PubMed
  54. Genet Med. 2014 Nov;16(11):854-61 - PubMed
  55. Health Expect. 2015 Dec;18(6):2296-305 - PubMed
  56. Health Inf Manag. 2011 Jun;40(2):39-43 - PubMed

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