Table 6.

The overall strength and direction of evidence

Results	Strength and direction of evidence
Patient-provider communication	+++
Monitor treatment response	++
Detect unrecognised problems	++
Changes to patient health behaviour	n/a
Changes to patient management	+
Improved patient satisfaction	+++
Improved health outcomes	+/0
Strong & effective quality improvement	n/a
Increased transparency, accountability, public reporting	n/a
Better system performance (monitoring, planning, financing, evaluating, responding)	n/a

Note: ++++: the strongest positive effect; xxxx: the strongest negative effect; n/a: not available; 0: mutual (no significant effect).