Table 2.

Supplementary key findings

Finding	Study type	Country	Reference
Users of these services were more likely to be female (OR 1.15), middle aged or older, with much greater morbidity than non-users (OR 5.6)	Cohort with match controls, cross-sectional cohort study	US	39, 40
People with Medicaid cover were less likely to use these services (OR 0.8) than people with commercial insurance	Cross-sectional cohort study	US	40
African–American, other non-white ethnicities, and females with lower socioeconomic classification were less likely to use the services	Randomised control trial, randomised control pilot study	US	29, 37
70% of clinicians felt that online access strengthened relationships, enhanced trust, and improved decision making	Quasi-experimental non-randomised design	US	45
Patients who used online access to test results were more satisfied than those who did not	Cluster randomised control trial	US	44
Use of a secure messaging tool improved patient satisfaction with care from 48% to 59% (P = 0.04)	Randomised control trial	US	35
Patients felt themselves better able to express their concerns in writing (34%), to communicate about difficult topics (36%), and to send psychosocial information when using online tools versus telephone	Randomised control trials (and interviews)	US, US	34, 35
Online systems saved patients time, telephone calls, and clinic visits	Randomised control trials (and interviews)	Norway, US	34, 35
About half of US patients were willing to pay for online access, and 21% were unwilling. Of those who were willing, the median value assigned was $2 per message	Randomised control trials, randomised control pilot study	Norway, US, US	33, 35, 37
Patients given online access to their records identified more than twice as many medication list discrepancies with potential for severe harm than those who did not	Cluster-randomised trial	US	43
Users of online services received 84% of preventive care services compared with 68% of controls, including influenza vaccine (22% versus 14%) and mammography (49% versus 30%); children whose parents used online services received 96% of immunisations versus 87% in controls. Online services also facilitated health maintenance/appointment reminders	Cluster randomised control trial	US	42
	Randomised control trials	UK, US	32, 36
Only 1–8% of patients say that viewing their record online caused confusion, worry, or offence	Quasi-experimental non-randomised design	US	45
The impact of online record access on patient use of face-to-face services and telephone calls was unclear	Randomised control trial (and interviews), cohort with match controls, quasi-experimental non-randomised design	Norway, US, US	34, 39, 45
	Randomised control trial, randomised control trial (and interviews), cohort and matched-control study, cluster randomised control trial	Norway, Norway, US, US	30, 34, 41, 42
Clinicians had concerns about the additional burden and workload from online access but found their fears only partly realised	Randomised control trial (and patient survey), three-part cohort study, quasi-experimental non-randomised design	US, US, US	31, 38, 45

OR = odds ratio.