全球范围内不断努力为患者提供患者可访问的电子健康记录(PAEHR),导致提供者之间的青少年和父母访问差异,regions,和国家。没有汇编证据来指导诸如访问年龄和父母代理访问范围之类的政策决定。在本文中,我们概述了我们对不同利益相关者(包括但不限于最终用户)观点的范围界定审查,使用,以及儿童基于网络访问电子健康记录(EHR)的经验,青少年,和父母。
这项研究的目的是确定,归类,并总结有关不同利益相关者的知识(例如,儿童和青少年,父母,卫生保健专业人员[HCPs],政策制定者,和患者门户或PAEHR的设计者)视图,使用,以及儿童使用EHR的经验,青少年,和父母。
根据Arksey和O\'Malley框架进行了范围审查。文献检索确定了符合条件的论文,这些论文侧重于儿童的EHR访问,青少年,以及在2007年至2021年之间发布的父母。许多数据库被用来搜索文献(PubMed,CINAHL,和PsycINFO)。
该方法产生了4817篇确定的文章和74篇(1.54%)包括的文章。这些论文主要是基于美国的观点,对父母的研究数量大于对青少年和HCP的总和。首先,青少年和家长没有机会预期低识字率和保密问题;然而,访问过记录的青少年和家长没有报告此类问题.第二,HCPs的主要问题是保持青少年保密.在为父母使用PAEHR之后,这仍然是一个问题,HCP,和其他利益相关者,但对青少年来说不是一个有经验的问题。第三,其他利益攸关方的观点为缓解问题提供了一些建议。最后,青少年需要教育,父母,和HCPs。
关于小儿PAEHRs的研究有限,特别是在美国以外,以及青少年基于网络访问其记录的经验。这些发现可以为未来有关获得PAEHR的法规的设计和实施提供信息。需要进一步检查青少年的经历,父母,和HCP来提高可用性和实用性,告知普遍原则,以减少全球提供者中儿童自身和父母使用EHR的当前随意性,并确保门户配备安全和适当地管理各种患者情况。
RR2-10.2196/36158。
Ongoing efforts worldwide to provide patients with patient-accessible electronic health records (PAEHRs) have led to variability in adolescent and parental access across providers, regions, and countries. There is no compilation of evidence to guide policy decisions in matters such as access age and the extent of parent proxy access. In this paper, we outline our scoping
review of different stakeholders\' (including but not limited to end users) views, use, and experiences pertaining to web-based access to electronic health records (EHRs) by children, adolescents, and parents.
The aim of this study was to identify, categorize, and summarize knowledge about different stakeholders\' (eg, children and adolescents, parents, health care professionals [HCPs], policy makers, and designers of patient portals or PAEHRs) views, use, and experiences of EHR access for children, adolescents, and parents.
A scoping
review was conducted according to the Arksey and O\'Malley framework. A literature search identified eligible papers that focused on EHR access for children, adolescents, and parents that were published between 2007 and 2021. A number of databases were used to search for literature (PubMed, CINAHL, and PsycINFO).
The approach resulted in 4817 identified articles and 74 (1.54%) included articles. The papers were predominantly viewpoints based in the United States, and the number of studies on parents was larger than that on adolescents and HCPs combined. First, adolescents and parents without access anticipated low literacy and confidentiality issues; however, adolescents and parents who had accessed their records did not report such concerns. Second, the main issue for HCPs was maintaining adolescent confidentiality. This remained an issue after using PAEHRs for parents, HCPs, and other stakeholders but was not an experienced issue for adolescents. Third, the viewpoints of other stakeholders provided a number of suggestions to mitigate issues. Finally, education is needed for adolescents, parents, and HCPs.
There is limited research on pediatric PAEHRs, particularly outside the United States, and on adolescents\' experiences with web-based access to their records. These findings could inform the design and implementation of future regulations regarding access to PAEHRs. Further examination is warranted on the experiences of adolescents, parents, and HCPs to improve usability and utility, inform universal principles reducing the current arbitrariness in the child\'s age for own and parental access to EHRs among providers worldwide, and ensure that portals are equipped to safely and appropriately manage a wide variety of patient circumstances.
RR2-10.2196/36158.