Conditions potentially sensitive to a personal health record (PHR) intervention, a systematic review.
BACKGROUND
Personal Health Records (PHRs) are electronic health records controlled, shared or maintained by patients to support patient centered care. The potential for PHRs to transform health care is significant; however, PHRs do not always achieve their potential. One reason for this may be that not all health conditions are sensitive to the PHR as an intervention. The goal of this review was to discover which conditions were potentially sensitive to the PHR as an intervention, that is, what conditions have empirical evidence of benefit from PHR-enabled management.


METHODS
A systematic review of Medline and CINAHL was completed to find articles assessing PHR use and benefit from 2008 to 2014 in specific health conditions. Two researchers independently screened and coded articles. Health conditions with evidence of benefit from PHR use were identified from the included studies.


RESULTS
23 papers were included. Seven papers were RCTs. Ten health conditions were identified, seven of which had documented benefit associated with PHR use: asthma, diabetes, fertility, glaucoma, HIV, hyperlipidemia, and hypertension. Reported benefits were seen in terms of care quality, access, and productivity, although many benefits were measured by self-report through quasi-experimental studies. No study examined morbidity/mortality. No study reported harm from the PHR.


CONCLUSIONS
There is a small body of condition specific evidence that has been published. Conditions with evidence of benefit when using PHRs tended to be chronic conditions with a feedback loop between monitoring in the PHR and direct behaviours that could be self-managed. These findings can point to other potentially PHR sensitive health conditions and guide PHR designers, implementers, and researchers. More research is needed to link PHR design, features, adoption and health outcomes to better understand how and if PHRs are making a difference to health outcomes.
Department of Family Practice, University of British Columbia, Vancouver, B.C., Canada. morgan@leadlab.ca.|Health Information Science, University of Victoria, Victoria, B.C., Canada. morgan@leadlab.ca.|Department of Computer Science, University of Victoria, Victoria, B.C., Canada. morgan@leadlab.ca.
Morgan
M
Price
Health Information Science, University of Victoria, Victoria, B.C., Canada.
Paule
P
Bellwood
Health Information Science, University of Victoria, Victoria, B.C., Canada.
Nicole
N
Kitson
Department of Family Practice, University of British Columbia, Vancouver, B.C., Canada.
Iryna
I
Davies
Department of Family Practice, University of British Columbia, Vancouver, B.C., Canada.|Health Information Science, University of Victoria, Victoria, B.C., Canada.|Department of Computer Science, University of Victoria, Victoria, B.C., Canada.
Jens
J
Weber
Health Information Science, University of Victoria, Victoria, B.C., Canada.
Francis
F
Lau
D002908:Chronic Disease; D019468:Disease Management; D055991:Health Records, Personal; D006801:Humans