title: The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.
abstract: BACKGROUND
  Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care.
  
  
  OBJECTIVE
  To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care.
  
  
  METHODS
  Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.
authors.affiliation: University of Surrey, Guildford, UK.
authors.forename: Freda
authors.initials: F
authors.lastname: Mold
authors.forename: Beverley
authors.initials: B
authors.lastname: Ellis
authors.forename: Simon
authors.initials: S
authors.lastname: de Lusignan
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
authors.forename: Jeremy C
authors.initials: JC
authors.lastname: Wyatt
authors.forename: Mary
authors.initials: M
authors.lastname: Cavill
authors.forename: Georgios
authors.initials: G
authors.lastname: Michalakidis
authors.forename: Fiona
authors.initials: F
authors.lastname: Barker
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
authors.forename: Tom
authors.initials: T
authors.lastname: Quinn
authors.forename: Phil
authors.initials: P
authors.lastname: Koczan
authors.forename: Theo
authors.initials: T
authors.lastname: Avanitis
authors.forename: Toto Anne
authors.initials: TA
authors.lastname: Gronlund
authors.forename: Christina
authors.initials: C
authors.lastname: Franco
authors.forename: Mary
authors.initials: M
authors.lastname: McCarthy
authors.forename: Zoë
authors.initials: Z
authors.lastname: Renton
authors.forename: Umesh
authors.initials: U
authors.lastname: Chauhan
authors.forename: Hannah
authors.initials: H
authors.lastname: Blakey
authors.forename: Neha
authors.initials: N
authors.lastname: Kataria
authors.forename: Simon
authors.initials: S
authors.lastname: Jones
authors.forename: Imran
authors.initials: I
authors.lastname: Rafi
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D057286:Electronic Health Records / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training; D020407:Internet; D017063:Outcome Assessment, Health Care; D033283:Patient Access to Records; D010349:Patient Compliance; D061214:Patient Safety; D011787:Quality of Health Care / Q000458:organization & administration*; D000078202:Systematic Reviews as Topic