The Impact of Patient Access to Electronic Health Records onHealth Care Engagement: Systematic Review

Background: Health information technologies, including electronic health records (EHRs), have revolutionized health caredelivery. These technologies promise to enhance the efficiency and quality of care through improved patient health informationmanagement. Despite the transformative potential of EHRs, the extent to which patient access contributes to increased engagementwith health care services within different clinical setting remains a distinct and underexplored facet. Objective: This systematic review aims to investigate the impact of patient access to EHRs on health care engagement.Specifically, we seek to determine whether providing patients with access to their EHRs contributes to improved engagementwith health care services. Methods: A comprehensive systematic review search was conducted across various international databases, including OvidMEDLINE, Embase, PsycINFO, and CINAHL, to identify relevant studies published from January 1, 2010, to November 15,2023. The search on these databases was conducted using a combination of keywords and Medical Subject Heading terms relatedto patient access to electronic health records, patient engagement, and health care services. Studies were included if they assessedthe impact of patient access to EHRs on health care engagement and provided evidence (quantitative or qualitative) for that. Theguidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement were followedfor study selection, data extraction, and quality assessment. The included studies were assessed for quality using the MixedMethods Appraisal Tool, and the results were reported using a narrative synthesis. Results: The initial search from the databases yielded 1737 studies, to which, after scanning their reference lists, we added 10studies. Of these 1747 studies, 18 (1.03%) met the inclusion criteria for the final review. The synthesized evidence from thesestudies revealed a positive relationship between patient access to EHRs and health care engagement, addressing 6 categories ofhealth care engagement dimensions and outcomes, including treatment adherence and self-management, patient involvement andempowerment, health care communication and relationship, patient satisfaction and health outcomes, use of health care resources,and usability concerns and barriers. Conclusions: The findings suggested a positive association between patient access to EHRs and health care engagement. Theimplications of these findings for health care providers, policy makers, and patients should be considered, highlighting the potentialbenefits and challenges associated with implementing and promoting patient access to EHRs. Further research directions havebeen proposed to deepen our understanding of this dynamic relationship