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首页> 外文期刊>JMIR Medical Informatics >Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study
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Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study

机译：迈向患者访问电子健康记录的采用框架：系统文献映射研究

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Background Patient access to electronic health records (EHRs) is associated with increased patient engagement and health care quality outcomes. However, the adoption of patient portals and personal health records (PHRs) that facilitate this access is impeded by barriers. The Clinical Adoption Framework (CAF) has been developed to analyze EHR adoption, but this framework does not consider the patient as an end-user. Objective We aim to extend the scope of the CAF to patient access to EHRs, develop guidance documentation for the application of the CAF, and assess the interrater reliability. Methods We systematically reviewed existing systematic reviews on patients' access to EHRs and PHRs. Results of each review were mapped to one of the 43 CAF categories. Categories were iteratively adapted when needed. We measured the interrater reliability with Cohen’s unweighted kappa and statistics regarding the agreement among reviewers on mapping quotes of the reviews to different CAF categories. Results We further defined the framework’s inclusion and exclusion criteria for 33 of the 43 CAF categories and achieved a moderate agreement among the raters, which varied between categories. Conclusions In the reviews, categories about people, organization, system quality, system use, and the net benefits of system use were addressed more often than those about international and regional information and communication technology infrastructures, standards, politics, incentive programs, and social trends. Categories that were addressed less might have been underdefined in this study. The guidance documentation we developed can be applied to systematic literature reviews and implementation studies, patient and informal caregiver access to EHRs, and the adoption of PHRs.
机译：背景，患者对电子健康记录（EHRS）的访问与增加的患者参与和保健质量结果有关。但是，通过障碍的患者门户和个人健康记录（PHR）的采用受到障碍的阻碍。临床采用框架（CAF）已经开发出来分析EHR采用，但该框架不会认为患者作为最终用户。目标我们的目标是将CAF的范围扩展到患者访问EHRS，制定申请CAF的指导文件，并评估Interray可靠性。方法我们系统地审查了对患者获得EHRS和PHRS的现有系统评价。每次审查的结果被映射到43个CAF类别中的一个。类别在需要时迭代地适应。我们通过Cohen的未加权Kappa和关于审查人员达成协议的统计数据来衡量了审查人员的协议的Interrader可靠性，以对不同的CAF类别的审查报价。结果我们进一步规定了43个CAF类别中33个框架的包含和排除标准，并在类别之间变化的评估者之间取得了适度的协议。结论在评论中，关于人，组织，系统质量，系统使用以及系统使用的净效益的分析比关于国际和区域信息和通信技术基础设施，标准，政治，激励计划以及社会趋势更频繁地解决了系统使用的净利润。在本研究中可能已经解决了较少所解决的类别。我们开发的指导文件可以应用于系统文献审查和实施研究，患者和非正式护理人员访问EHR，以及采用PHRS。

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