Table 1

Characteristics of the included studies

Author, yearStudy typeN* (I;C)Date of interventionParticipants (setting)DurationStudy design and comparisonRetention rates (%) total (I:C)Intervention
EHR-sharing componentOther components of the intervention
Chrischilles, 201329RCT1075
(I:802;
C:273)
2010–2011General population (>65 years old)
(general public—survey to voters)
6 M2-arm study
Standard care control group
100.0 (I:100.0; C:100.0)
  • Web-based health record

  • Access to current and past medicines, allergies, health conditions, and health event tracking over time

  • Medication safety messages

  • Display of general medication-use patient safety indicators

Earnest, 200421RCT107
(I:54;
C:53)
2002Patients with chronic heart failure
(secondary care)
12 M2-arm study
Standard care control group
75.7
(I:70.4; C:81.1)
  • Web-based health record

  • Access to medical record with clinical notes, laboratory reports, and test results, as well as information regarding heart failure

  • Secure messaging system

Fonda, 200914RCT104
(I:52; C:52)
NAPatients with poorly controlled T2DM
(primary and secondary care)
12 M2-arm study
Standard care control group
NA
  • Web-based health record

  • Access to website which accepts electronic transmissions from blood pressure and glucose monitoring devices and displays these data in graphic and tabular form for the participant and care manager to review

  • Secure messaging system

  • Web-enabled diabetes educational modules

  • Links to other web-based diabetes resources

Grant, 200833RCT244
(I:126; C:118)
2005–
2007
General population
(primary care)
12 M2-arm study
Active care control group
(ie, access to a PHR to update and submit family history and health maintenance information)
64.0
(I:65.0; C:34.7)
  • Web-based health record

  • Access to medications lists, glucose, blood pressure, LDL-cholesterol, preventive care and recent results and current treatment information

  • Secure messaging system (platform to reply to questions regarding adherence barriers and adverse effects of medication; check boxes and free text boxes within the PHR encouraged patients to enter therapy concerns and requests to address specific care limitations)

Green,
200823
RCT778
(I1:259;
I2:261; C:258)
NAHypertensive patients
(primary and secondary care)
12 M3-arm study
Standard care control group
Intervention 1(I1): home BP monitoring and secure patient Web services training only
Intervention 2(I2): home BP monitoring and Web training plus pharmacist care management delivered through web communications
In this work, only control and intervention one were considered
93.8
(I1:94.9; I2:90.8; C:95.7)
  • Web-based health record

  • Ability to view current health conditions, laboratory test results, clinic visit summaries, and lists of allergies, immunisations, and medications

  • Secure messaging system

  • Ability to refill medications and make appointments

Holbrook, 200915RCT511
(I:253;
C:258)
2002–
2003
Patients with type 2 diabetes
(primary care)
6 M2-arm study
Standard care control group
68.7 (I:68.4; C:69.0)
  • Patient and primary care provider access to diabetes tracker of 13 risk factors

  • Targets of risk factors

  • Personalised recommendation messages

  • Appointment and medication reminders

Jones,
199925
RCT525
(I1:167;
I2:178;
C:180)
1997Radiotherapy patients (secondary care)3 M3-arm study
Standard care control group
Intervention 1(I1): Access to general information on a computer)
Intervention 2(I2): Access to personal and general information in varying order via a computer
In this work only comparisons between control and I2 will be considered
83.4
(I1:76.6; I2:87.6; C:85.6)
  • Touch screen health record kiosk

  • Summary of medical record, or choice between personal or general information

  • Printout of information viewed sent to patients

  • Explanation about terms used were linked to in the medical records

  • General information about cancer

Khan,
201016
RCT7368
(I:3856; C:3512)
NAPatients with type 2 diabetes (primary and secondary care)32 M2-arm study
Standard care control group
100.0
(I:100.0; C:100.0)
  • Centralised laboratory results from independent laboratories (haemoglobin A1c, cholesterol, serum creatinine, and urine protein results) accessible to patients

  • Overdue reminders and alerts to patients with elevated test results

  • Generation of flow sheets with laboratory results, reminders of overdue laboratory tests, and summary population reports for providers

Krist,
201232
RCT4500 (I:2250: C:2250)2008–
2009
General population
(primary care)
16 M2-arm study
Standard care control group
NA
  • Access to relevant details in the patient’s history (prior laboratory test values and dates)

  • Preventive services recommendations based on EHR data

  • Links to relevant informational material and decision aids

McCarrier, 200926RCT78
(I:42;
C:36)
2005–
2006
Patients with type 1 diabetes (primary care)12 M2-arm study
Standard care control group
83.3 (I:85.7; C:80.6)
  • Web-based health record

  • Access to entire EHR with clinical encounters, physician notes, and test results

  • Blood glucose readings uploaded by patients

  • Medication, nutrition, and exercise data can be registered by both patients and case managers

  • Generations of action plans for self-efficacy and self-management support

  • Educational information on diabetes

McMahon, 200517RCT104
(I:52; C:52)
2004Patients with type 2 diabetes patients (both primary and secondary care)12 M2-arm study
Standard care control group
75.9 (I:75.0; C:76.9)
  • Web-based care-management site with value upload for blood pressure and glucose monitoring devices

  • Graphical and tabular view of measurements provided for patients and HCPs

  • Half-day self-management training on diabetes

  • Computer training and support available to intervention participants

  • Messaging with care manager via site

  • Educational material

Nagykaldi, 201231CRT384
(I:NA;
C:NA)
NAGeneral population (primary care)12 M2-arm study
Standard care control group
68.5
(I:NA;
C:NA)
  • Web-based patient portal with option to manage health information and download a personal health record

  • Personalised wellness plan, prevention and longitudinal health information available

Quinn, 200819RCT26
(I:13; C:13)
2006Patients with type 2 diabetes patients (primary care)3 M2-arm study
Standard care control group
NA
  • Blood glucose meter value sent directly to the patient’s mobile phone

  • Real-time feedback on blood glucose levels

  • Display of medications

  • Educational information

Ralston, 200918RCT83
(I:42;
C:41)
2002–
2004
Patients with type 2 diabetes
(secondary care)
12 M2-arm study
Standard care control group
90.3 (I:92.95; C:87.8)
  • Web-based EHR access

  • Feedback on blood glucose measurements

  • Messaging system for patients and staff

  • Educational information (exercise, diet and medication)

Ross,
200422
RCT107
(I:54;
C:53)
2001Patients with heart failure (secondary care)12 M2-arm study
Standard care control group
75.7
(I:81.1;
C:70.3)
  • Web-based EHR access practice

  • Messaging system for patients and staff

  • Educational information

Schnipper, 201230CRT541
(I:267;
C:274)
2005–
2007
General population
(primary care)
NA2-arm study
Active care control group
(ie, patients received a different EHR-linked intervention)
74.3%
(I:100.0%
C:49.3%)
  • Web-based medication module linked to EHR

  • Ability to request appointments and referrals

  • Communication with their physician via secure email

  • Prescription renewals and access a health information library

Shaw,
200828
RCT193
(I:97;
C:96)
2004–
2006
Maternity centre
(primary care)
NA2-arm study
Active care control group
(ie, patients received access to the same website but with links to general pregnancy health information alone)
54.9
(I:64.9; C:44.8)
  • Web-based access to antenatal health record

  • Access to general pregnancy health information website for control and intervention groups

Tang,
201320
RCT415
(I:202; C:213)
2008–
2009
Patients with type 2 diabetes patients (both primary and secondary care)12 M2-arm study
Standard care control group
91.3
I:92.0; C:90.6
  • Web-based patient portal access to EHR

  • Automatic upload of blood glucose values with visual feedback; Personalised diabetes summary; nutrition, exercise, and insulin records

  • Online messaging with HCPs

  • Advice and medication management from HCPs

  • Personalised e-educational materials

Tuil,
200727
RCT244
(I:122;
C:122)
2004Patients undergoing IVF or ICSI (secondary care)NA2-arm study
Standard care control group
73.7
(I:83.6; C:63.9)
  • Web-based EHR

  • Personal and general information regarding treatment

  • Communication with other patients and HCPs

Wagner, 201224CRT443
(I:194;
C:252)
NAPatients with hypertension
(both primary and secondary care)
12 M2-arm study
Standard care control group
71.9
(I:61.8;
C:75.8)
  • Web-based EHR

  • Patients could view problem and medication lists, information on allergies and immunisation

  • Messaging function, educational materials, medication interaction checking, health measurement tracking, and health diaries

  • *Total number of participants randomised for each study.

  • †Retention rates were calculated as the proportion of patients randomised in each study that completed follow-up.

  • BP, blood pressure; C, Control group; CRT, cluster randomised trial; EHR, electronic health records; HCP, healthcare professionals; I, Intervention group; ICSI, intracytoplasmic sperm injection; IVF, in vitro fertilisation; LDL, low-density lipoprotein; M, months; NA, information not available; PHR, personal health record; RCT, randomised controlled trial; T2DM, type 2 diabetes mellitus.