TY - JOUR AU - Schwarz, Julian AU - Bärkås, Annika AU - Blease, Charlotte AU - Collins, Lorna AU - Hägglund, Maria AU - Markham, Sarah AU - Hochwarter, Stefan PY - 2021 DA - 2011/12/14 TI -与受精神健康问题影响的人分享临床笔记和电子健康记录:范围审查乔- JMIR表示“状态”卫生SP - e34170六世- 8 - 12 KW -电子健康记录KW -打开notes KW -用户参与KW -病人倡导KW -病人门户KW -病人权利KW -合作医疗KW -参与KW -协同生产KW - AB系统转换KW——医疗改革背景:电子健康记录(EHRs)正日益在国际上实现的,而数字共享电子医疗纪录与服务用户(SUs)是一种相对较新的实践。对患者可访问的电子病历(PAEHRs)的研究——通常被称为开放病历——在普通医学环境中显示出了有希望的结果。然而，在精神卫生保健(MHC)环境中进行的研究强调了几个需要进一步探索的伦理和实践挑战。目的:这篇范围综述旨在绘制MHC中PAEHRs的可用证据。我们试图将研究结果与来自其他卫生背景的研究联系起来，比较不同利益攸关方的观点、期望、PAEHRs的实际经验，并确定潜在的研究差距。方法:采用6个电子数据库进行系统范围回顾。截至2021年9月，重点是与受精神健康问题影响的人以数字方式共享临床记录或电子病历的研究也包括在内。混合方法评价工具用于评估研究的质量。PRISMA(系统回顾和荟萃分析首选报告项目)范围回顾扩展指导叙述综合和报告发现。 Results: Of the 1034 papers screened, 31 were included in this review. The studies used mostly qualitative methods or surveys and were predominantly published after 2018 in the United States. PAEHRs were examined in outpatient (n=29) and inpatient settings (n=11), and a third of all research was conducted in Veterans Affairs Mental Health. Narrative synthesis allowed the integration of findings according to the different stakeholders. First, SUs reported mainly positive experiences with PAEHRs, such as increased trust in their clinician, health literacy, and empowerment. Negative experiences were related to inaccurate notes, disrespectful language use, or uncovering of undiscussed diagnoses. Second, for health care professionals, concerns outweigh the benefits of sharing EHRs, including an increased clinical burden owing to more documentation efforts and possible harm triggered by reading the notes. Third, care partners gained a better understanding of their family members’ mental problems and were able to better support them when they had access to their EHR. Finally, policy stakeholders and experts addressed ethical challenges and recommended the development of guidelines and trainings to better prepare both clinicians and SUs on how to write and read notes. Conclusions: PAEHRs in MHC may strengthen user involvement, patients’ autonomy, and shift medical treatment to a coproduced process. Acceptance issues among health care professionals align with the findings from general health settings. However, the corpus of evidence on digital sharing of EHRs with people affected by mental health conditions is limited. Above all, further research is needed to examine the clinical effectiveness, efficiency, and implementation of this sociotechnical intervention. SN - 2368-7959 UR - https://mental.www.mybigtv.com/2021/12/e34170 UR - https://doi.org/10.2196/34170 UR - http://www.ncbi.nlm.nih.gov/pubmed/34904956 DO - 10.2196/34170 ID - info:doi/10.2196/34170 ER -