Excerpt

As the Veterans Health Administration (VHA) expands the capabilities of its personal health record system, My HealtheVet (MHV), and places greater emphasis on encouraging its use, it is interested in understanding how best to prioritize different functionalities and which of them will provide the greatest benefits to Veterans. This systematic review was designed to evaluate the literature surrounding secure messaging systems and electronic applications that give patients access to their own medical records, specifically investigating the outcomes, patient satisfaction, healthcare utilization and efficiency, and adherence. Additionally, the review examined studies that evaluated attitudes, particularly regarding patients having online access to their own medical information. The review distinguished between electronic systems that were “tethered” or tied to existing healthcare institution systems similar to how MHV is tethered to VHA’s electronic health record systems (EHR), versus those that were “stand-alone.”

Contents

• PREFACE
• EXECUTIVE SUMMARY
  • BACKGROUND
  • METHODS
  • DATA SYNTHESIS
  • PEER REVIEW
  • RESULTS
  • CONCLUSIONS
  • DISCUSSION
• INTRODUCTION
• METHODS
  • TOPIC DEVELOPMENT
  • SEARCH STRATEGY
  • STUDY SELECTION
  • DATA ABSTRACTION
  • QUALITY ASSESSMENT
  • DATA SYNTHESIS
  • RATING THE BODY OF EVIDENCE
  • PEER REVIEW
• RESULTS
  • LITERATURE FLOW
  • KEY QUESTION #1 What is the association between secure messaging and health outcomes, patient satisfaction, adherence, efficiency or utilization, or automated email?
  • KEY QUESTION #2 What is the association between patient access to their own medical record and health outcomes, patient satisfaction, adherence, efficiency or utilization, and attitudes about access?
• SUMMARY AND DISCUSSION
  • SUMMARY OF EVIDENCE BY KEY QUESTION
  • LIMITATIONS
  • DISCUSSION
  • RECOMMENDATIONS FOR FUTURE RESEARCH
  • CONCLUSIONS
• REFERENCES
• APPENDIX A SEARCH STRATEGY
• APPENDIX B STUDY SELECTION FORM
• APPENDIX C CRITERIA USED IN QUALITY ASSESSMENT
• APPENDIX D PEER REVIEW COMMENTS/AUTHOR RESPONSE
• APPENDIX E EVIDENCE TABLES

Prepared for: Department of Veterans Affairs, Veterans Health Administration, Quality Enhancement Research Initiative, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Evidence-based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, Paul G. Shekelle, M.D., Ph.D., Director.

Suggested citation:

Goldzweig CL, Towfigh AA, Paige NM, Orshansky G, Haggstrom DA, Beroes JM, Miake-Lye IM, Shekelle PG. Systematic Review: Secure Messaging between Providers and Patients, and Patients’ Access to Their Own Medical Record. Evidence on Health Outcomes, Satisfaction, Efficiency and Attitudes. VA-ESP Project #05-226, 2012.

This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the West Los Angeles VA Medical Center, Los Angeles, CA funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.