An Overview of Reviews of Personal Health Records (PHRs) and Portals: Barriers, Enablers and Benefits.




Denman, Steve

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Background: Personal Health Records (PHRs) and Patient Portals (Portals) are said to be facilitators of a new paradigm emerging in the delivery of healthcare where the patients are empowered to take an active role in their health by setting goals and making decisions from gaining a greater understanding of one’s conditions and treatment options. These systems have the potential to increase patient engagement, improve communication between patient and the healthcare system, and enable the healthcare system to move towards a more personalized medical model. Despite the promises of these systems, recent studies have identified barriers to use from both patients and providers, and limited conclusive benefits. Objective: To explore previous research that have examined the use of PHRs and Portals in order to identify any barriers, enablers and benefits of use. Method: An overview of reviews was conducted to present the barriers, enablers and benefits of PHR and Portal use as identified in systematic reviews over the past 10 years. Eleven systematic reviews were evaluated and selected for the overview. An adapted Clinical Adoption Framework was used to capture the findings of the reviews and to show how they interlinked and influenced each other. Conclusion: Several barriers to use were identified, namely, the socio-economic background of users, the patient’s and provider’s beliefs of the system, and the usability and usefulness of the systems. An enabler of use included encouragement from social supports and providers to use these systems. The use of PHRs and Portals do appear to produce some benefits, such as improved communication. However, the ability of these systems to empower patients leading to positive health outcomes remains to be confirmed with inconclusive results being reported for improvements in self-care and/or management or participation in care, and inconclusive results for improvements in disease/health outcomes. Recommendations for future research and implementation of PHRs and Portals include improving access and use for those who are less empowered, developing systems to meet the needs of patient and providers, and ensuring users are encouraged and supported to use these systems once implemented.



Personal Health Record, PHR, Patient Portal, Barriers, Enablers, Benefits, Outcomes, Clinical Adoption Framework