Abstract：
OBJECTIVE: To identify the key requirements and challenges to interoperability between patient portals and electronic health records (EHRs).
BACKGROUND: Patient portals provide patients with access to their health information directly from EHRs within hospitals, primary care centres and general practices (GPs). Patient portals offer many benefits to patients including improved communication with healthcare providers and care coordination. However, many challenges exist with the integration and automatic and secure sharing of information between EHRs and patient portals. It is critical that countries learn from international experiences to successfully develop interoperable national patient portals.
METHODS: A scoping review methodology was undertaken. A search strategy using index terms and keywords was applied across four key databases, an additional grey literature search was also run. The identified studies were screened by two reviewers to determine eligibility against defined inclusion criteria. Data were abstracted from the eligible studies and reviewed to identify the key requirements and challenges to interoperability of patient portals with EHRs.
RESULTS: After screening 3,462 studies, 34 were included across 11 countries. Of the 29 unique patient portals studied, few offered patients access to their entire healthcare record across multiple sites and a number of different functionalities were available. Key interoperability requirements and challenges identified were: Data Sharing Incentives & Supports; Heterogenous Organisations & Information Systems; Data Storage & Management; Available Information & Functionalities; Data Formats & Standards; Identification of Individuals; User Access, Control & Consent; and Security & Privacy.
CONCLUSIONS: Seamless exchange of health information across patient portals and EHRs required organisational and individual factors, as well as technical considerations. Interorganisational collaboration and engagement of key stakeholders to determine standards and guidelines for consent and sharing of information, as well as technical standards and security measures were recommended.
BACKGROUND: Patient portals provide patients with access to their health information directly from EHRs within hospitals, primary care centres and general practices (GPs). Patient portals offer many benefits to patients including improved communication with healthcare providers and care coordination. However, many challenges exist with the integration and automatic and secure sharing of information between EHRs and patient portals. It is critical that countries learn from international experiences to successfully develop interoperable national patient portals.
METHODS: A scoping review methodology was undertaken. A search strategy using index terms and keywords was applied across four key databases, an additional grey literature search was also run. The identified studies were screened by two reviewers to determine eligibility against defined inclusion criteria. Data were abstracted from the eligible studies and reviewed to identify the key requirements and challenges to interoperability of patient portals with EHRs.
RESULTS: After screening 3,462 studies, 34 were included across 11 countries. Of the 29 unique patient portals studied, few offered patients access to their entire healthcare record across multiple sites and a number of different functionalities were available. Key interoperability requirements and challenges identified were: Data Sharing Incentives & Supports; Heterogenous Organisations & Information Systems; Data Storage & Management; Available Information & Functionalities; Data Formats & Standards; Identification of Individuals; User Access, Control & Consent; and Security & Privacy.
CONCLUSIONS: Seamless exchange of health information across patient portals and EHRs required organisational and individual factors, as well as technical considerations. Interorganisational collaboration and engagement of key stakeholders to determine standards and guidelines for consent and sharing of information, as well as technical standards and security measures were recommended.
摘要：
目的：确定患者门户和电子健康记录（EHRs）之间互操作性的关键要求和挑战。
背景：患者门户为患者提供直接从医院内的EHR获取其健康信息的途径，初级保健中心和一般做法（GP）。患者门户为患者提供许多好处，包括改善与医疗保健提供者的沟通和护理协调。然而,EHR和患者门户之间的信息集成和自动安全共享存在许多挑战.各国必须借鉴国际经验，成功开发可互操作的国家患者门户网站。
方法：进行范围审查方法。在四个关键数据库中应用了使用索引术语和关键字的搜索策略，还进行了额外的灰色文献检索。确定的研究由两名评审员筛选，以根据定义的纳入标准确定资格。从符合条件的研究中提取数据，并进行审查，以确定患者门户与EHR的互操作性的关键要求和挑战。
结果：筛选3,462项研究后，包括11个国家/地区的34个。在研究的29个独特的患者门户中，很少有人向患者提供跨多个站点的完整医疗记录,并且提供了许多不同的功能.确定的主要互操作性要求和挑战包括：数据共享激励和支持；异构组织和信息系统；数据存储和管理；可用信息和功能；数据格式和标准；个人识别；用户访问，控制和同意；以及安全和隐私。
结论：患者门户和EHR之间健康信息的无缝交换需要组织和个人因素，以及技术方面的考虑。组织间协作和关键利益相关者的参与，以确定同意和信息共享的标准和准则，以及建议的技术标准和安全措施。
背景：患者门户为患者提供直接从医院内的EHR获取其健康信息的途径，初级保健中心和一般做法（GP）。患者门户为患者提供许多好处，包括改善与医疗保健提供者的沟通和护理协调。然而,EHR和患者门户之间的信息集成和自动安全共享存在许多挑战.各国必须借鉴国际经验，成功开发可互操作的国家患者门户网站。
方法：进行范围审查方法。在四个关键数据库中应用了使用索引术语和关键字的搜索策略，还进行了额外的灰色文献检索。确定的研究由两名评审员筛选，以根据定义的纳入标准确定资格。从符合条件的研究中提取数据，并进行审查，以确定患者门户与EHR的互操作性的关键要求和挑战。
结果：筛选3,462项研究后，包括11个国家/地区的34个。在研究的29个独特的患者门户中，很少有人向患者提供跨多个站点的完整医疗记录,并且提供了许多不同的功能.确定的主要互操作性要求和挑战包括：数据共享激励和支持；异构组织和信息系统；数据存储和管理；可用信息和功能；数据格式和标准；个人识别；用户访问，控制和同意；以及安全和隐私。
结论：患者门户和EHR之间健康信息的无缝交换需要组织和个人因素，以及技术方面的考虑。组织间协作和关键利益相关者的参与，以确定同意和信息共享的标准和准则，以及建议的技术标准和安全措施。
