title: Patient access to medical records and healthcare outcomes: a systematic review.
abstract: OBJECTIVE
  We conducted a systematic review to determine the effect of providing patients access to their medical records (electronic or paper-based) on healthcare quality, as defined by measures of safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.
  
  
  METHODS
  Articles indexed in PubMed from January 1970 to January 2012 were reviewed. Twenty-seven English-language controlled studies were included. Outcomes were categorized as measures of effectiveness (n=19), patient-centeredness (n=16), and efficiency (n=2); no study addressed safety, timeliness, or equity.
  
  
  RESULTS
  Outcomes were equivocal with respect to several aspects of effectiveness and patient-centeredness. Efficiency outcomes in terms of frequency of in-person and telephone encounters were mixed. Access to health records appeared to enhance patients' perceptions of control and reduced or had no effect on patient anxiety.
  
  
  CONCLUSIONS
  Although few positive findings generally favored patient access, the literature is unclear on whether providing patients access to their medical records improves quality.
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA Graduate College of Social Work, University of Houston, Houston, Texas, USA.
authors.forename: Traber
authors.initials: T
authors.lastname: Davis Giardina
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Shailaja
authors.initials: S
authors.lastname: Menon
authors.affiliation: Graduate College of Social Work, University of Houston, Houston, Texas, USA.
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Parrish
authors.affiliation: University of Texas School of Biomedical Informatics and the UT-Memorial Hermann Center for Healthcare Quality & Safety, Houston, Texas, USA.
authors.forename: Dean F
authors.initials: DF
authors.lastname: Sittig
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Hardeep
authors.initials: H
authors.lastname: Singh
mesh_terms: D057286:Electronic Health Records / Q000458:organization & administration*; D055991:Health Records, Personal; D006801:Humans; D008499:Medical Records; D017063:Outcome Assessment, Health Care; D033283:Patient Access to Records; D010358:Patient Participation; D018802:Patient-Centered Care; D011787:Quality of Health Care
keywords: Patient Access; Personal Health Record