Elizabeth Manias1, Tracey Bucknall2, Nilmini Wickramasinghe3, Kathleen Gray4, Jonathan Schaffer5, Ellie Rosenfeld6. 1. School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia 3125. Electronic address: emanias@deakin.edu.au. 2. School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia 3125; Centre for Quality and Patient Safety Research, Alfred Health Partnership, Alfred Health, Commercial Road, Prahran, Victoria, Australia, 3181. Electronic address: tracey.bucknall@deakin.edu.au. 3. Iverson Health Innovation Research Institute, Swinburne University of Technology, John Street, Hawthorn, Victoria Australia, 3122. Electronic address: nilmini.work@gmail.com. 4. Health and Biomedical Informatics Centre, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Grattan Street, Parkville Victoria Australia, 3010. Electronic address: kgray@unimelb.edu.au. 5. Center for Joint Replacement, Department of Orthopaedic Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio USA, 44195. Electronic address: SCHAFFJ@ccf.org. 6. School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia 3125. Electronic address: mimi7@westnet.com.au.
Abstract
BACKGROUND: Use of electronic medical records (EMRs) in hospitals affects how individuals communicate with each other. OBJECTIVE: To examine how EMRs mediate communication between inpatients, their families, and health professionals to support patient and family engagement in care. METHODS: The following electronic bibliographic databases were searched for relevant studies: Association for Computing Machinery Digital Library, CINAHL, Medline, the Cochrane Central Register of Controlled Trials, PsycInfo, and EMBASE. RESULTS: The search identified 850 papers, and of these, 32 met the inclusion criteria. Interactions with the EMR tended to be unidirectional in nature, where health professionals consulted with patients and families to update patient information. Engagement rarely extended to facilitating patient and family participation beyond consultation. There were few examples of patient and family partnership and shared leadership, mainly with secure messaging and use of the patient portal. Strategies that worked in facilitating active engagement involved patients and families employing creative means of gathering information and directing this information to health professionals. Use of such strategies were rare and involved the attributes of particular individuals, rather than considering the inherent culture of clinical settings. CONCLUSION: Further research is urgently needed to examine possibilities of patient and family involvement in treatment modalities, and partnership and shared governance in using the EMR.
BACKGROUND: Use of electronic medical records (EMRs) in hospitals affects how individuals communicate with each other. OBJECTIVE: To examine how EMRs mediate communication between inpatients, their families, and health professionals to support patient and family engagement in care. METHODS: The following electronic bibliographic databases were searched for relevant studies: Association for Computing Machinery Digital Library, CINAHL, Medline, the Cochrane Central Register of Controlled Trials, PsycInfo, and EMBASE. RESULTS: The search identified 850 papers, and of these, 32 met the inclusion criteria. Interactions with the EMR tended to be unidirectional in nature, where health professionals consulted with patients and families to update patient information. Engagement rarely extended to facilitating patient and family participation beyond consultation. There were few examples of patient and family partnership and shared leadership, mainly with secure messaging and use of the patient portal. Strategies that worked in facilitating active engagement involved patients and families employing creative means of gathering information and directing this information to health professionals. Use of such strategies were rare and involved the attributes of particular individuals, rather than considering the inherent culture of clinical settings. CONCLUSION: Further research is urgently needed to examine possibilities of patient and family involvement in treatment modalities, and partnership and shared governance in using the EMR.
Authors: Kim E Alexander; Theodora Ogle; Hana Hoberg; Libbie Linley; Natalie Bradford Journal: BMC Health Serv Res Date: 2021-02-15 Impact factor: 2.655