The patient perspective on the effects of medical record accessibility: a systematic review

Abstract

Background: Health care is shifting from a paternalistic to a participatory model, with increasing patient involvement. Medical record accessibility to patients may contribute significantly to patient comanagement. Objectives: To systematically review the literature on the patient perspective of effects of personal medical record accessibility on the individual patient, patient-physician relationship and quality of medical care. Methods: Screening of PubMed, Web of Science, Cinahl, and Cochrane Library on the keywords medical record', patient record', communication', patient participation', doctor-patient relationship', physician-patient relationship' between 1 January 2002 and 31 January 2016; systematic review after assessment for methodological quality. Results: Out of 557 papers screened, only 12 studies qualified for the systematic review. Only a minority of patients spontaneously request access to their medical file, in contrast to frequent awareness of this patient right and the fact that patients in general have a positive view on open visit notes. The majority of those who have actually consulted their file are positive about this experience. Access to personal files improves adequacy and efficiency of communication between physician and patient, in turn facilitating decision-making and self-management. Increased documentation through patient involvement and feedback on the medical file reduces medical errors, in turn increasing satisfaction and quality of care. Information improvement through personal medical file accessibility increased reassurance and a sense of involvement and responsibility. Conclusion: From the patient perspective medical record accessibility contributes to co-management of personal health care.