The Impact of Patient Access to Their Electronic Health Record on Medication Management Safety: A Narrative Review

Abstract

Introduction: As the American's Federal Health Insurance Portability and Accountability Act (HIPAA) stated that patients should be allowed to review their medical records, and as information technology is ever more widely used by healthcare professionals and patients, providing patients with online access to their own medical records through a patient portal is becoming increasingly popular. Previous research has been done regarding the impact on the quality and safety of patients' care, rather than explicitly on medication safety, when providing those patients with access to their electronic health records (EHRs).

Aim: This narrative review aims to summarise the results from previous studies on the impact on medication management safety concepts of adult patients accessing information contained in their own EHRs.

Result: A total of 24 studies were included in this review. The most two commonly studied measures of safety in medication management were: (a) medication adherence and (b) patient-reported experience. Other measures, such as: discrepancies, medication errors, appropriateness and Adverse Drug Events (ADEs) were the least studied.

Conclusion: The results suggest that providing patients with access to their EHRs can improve medication management safety. Patients pointed out improvements to the safety of their medications and perceived stronger medication control. The data from these studies lay the foundation for future research.

Keywords: ACOVE, Assessing Care Of Vulnerable Elders; ADE, Adverse Drug Events; CI, Confidence Interval; EHR, Electronic Health Record; Electronic health record; Electronic medical records; HIPAA, American’s Federal Health Insurance Portability and Accountability Act; HIV/AIDS, Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome; LMR, Longitudinal Medical Record; MHV, MyHealtheVet; OR, Odds Ratio; OTC, over-the-counter; PAERS, Patient Access to Electronic Records System; PCP, Primary Care Physician; PDC, Proportion of Days Covered; PG, Patient Gateway; PHR, Personal Health Record; Patient access and medication management; Patient participation; RCT, Randomised Controlled Trial; RR, Relative Risk; SPARO, System Providing Access to Records Online; UK, United Kingdom; USA, United States of America; VA, Veterans Affairs; WDS, WellDoc System.