Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review

BMC Medical Informatics and Decision Making

Andrew Georgiou¹  Habibollah Pirnejad²  Esmaeel Toni²  Zahra Niazkhani³  Mojgan Cheshmekaboodi⁴ 

[1] Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University;Department of Health Information Technology, Urmia University of Medical Sciences;Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences;Office for Disease Registry and Health Outcomes, Urmia University of Medical Sciences;

关键词: Personal health records;    Systematic reviews;    ePHR;    Self-care;    Chronic diseases;   

DOI  :  10.1186/s12911-020-01159-1

来源: DOAJ

【 摘 要 】

Abstract Background Electronic personal health records (ePHRs) are defined as electronic applications through which individuals can access, manage, and share health information in a private, secure, and confidential environment. Existing evidence shows their benefits in improving outcomes, especially for chronic disease patients. However, their use has not been as widespread as expected partly due to barriers faced in their adoption and use. We aimed to identify the types of barriers to a patient, provider, and caregiver adoption/use of ePHRs and to analyze their extent in chronic disease care. Methods A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) database was performed to find original studies assessing barriers to ePHR adoption/use in chronic care until the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the quality of evidence in the included studies. Results Sixty publications met our inclusion criteria. Issues found hindering ePHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting ePHRs due to workload, lack of reimbursement, and lack of user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings, and providers involved in chronic care). Conclusions ePHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating ePHR adoption/use in chronic disease care. A deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced ePHR adoption/use.

【 授权许可】

Unknown