Work system barriers to patient, provider, and caregiver use of personal health records: A systematic review

Abstract

ObjectivesThis review applied a human factors/ergonomics (HF/E) paradigm to assess individual, work system/unit, organization, and external environment factors generating barriers to patient, provider, and informal caregiver personal health record (PHR) use. MethodsThe literature search was conducted using five electronic databases for the timeframe January 2000 to October 2013, resulting in 4865 citations. Two authors independently coded included articles (n = 60). ResultsFifty-five, ten and five articles reported barriers to patient, provider and caregiver PHR use, respectively. Barriers centered around 20 subfactors. The most frequently noted were needs, biases, beliefs, and mood (n = 35) and technology functions and features (n = 32). ConclusionsThe HF/E paradigm was effective in framing the assessment of factors creating barriers to PHR use. Design efforts should address literacy, interoperability, access to health information, and secure messaging. A deeper understanding of the interactions between work systems and the role of organization and external environment factors is required.