Table 1.
Study design, research focus and Mixed Methods Appraisal Tool (MMAT) score of included studies.
| Reference | MMAT score | Study design | Study or intervention aim |
| Ralston et al 2004 [32] | 50 | Qualitative study using semistructured interviews | To explore the experiences of diabetes management with CMRsa use |
| Hess et al 2006 [33] | 25 | Survey and focus group follow up interviews | To evaluate a CMR portal with customized portal features |
| Shea et al 2006 [34] | 100 | RCTb | To evaluate impact of home telemedicine unit to usual care, on clinical outcomes |
| Harris et al 2009 [35] | 75 | Cross-sectional survey | To determine if CMR use is linked to higher quality of care and lower outpatient utilization |
| Hess et al 2007 [36] | 75 | Focus groups pre- and postimplementation | To assess patient reaction and challenges with eHealth technology |
| Ralston et al 2009 [37] | 75 | Pilot RCT | To test Web-based care management of glycemic control using CMRs |
| Roblin et al 2009 [38] | 50 | Longitudinal cohort survey and clustered randomized design | To assess racial preference for registering with a Kaiser Permanente CMR system |
| Sarkar et al 2010 [39] | 75 | Survey | Compare use of portal for English-speaking patients versus patients with limited health literacy |
| Wald et al 2010 [40] | 75 | RCT-survey | To describe patients experiences of previsit e-Journal use |
| Weppner et al 2010 [41] | 75 | Retrospective cohort study | To evaluate the use of SMRc between older patients and provider |
| Bredfeldt et al 2011 [42] | 75 | Retrospective study | To determine the relationship between effectiveness SMd or phone calls and Diabetes Recognition Program scores |
| Tenforde et al 2011 [43] | 100 | Retrospective audit | To measure the association of CMR use per days and diabetes quality measures |
| Grembowski et al 2012 [44] | 75 | Single interrupted time series-design | To examine whether a Group Health Co-operative changed utilization and cost of care |
| Lyles et al 2012 [45] | 75 | Cross-sectional survey | To assess the relationship between race or ethnicity and CMR use |
| Wade-Vuturo 2013 [46] | 75 | Mixed methods plus focus groups and survey | To explore how adults with T2DMe use a patient portal, to understand nonusers perspectives; and the relationship between SM and glycemic control |
| Berryman et al 2013 [47] | 75 | Cross-sectional, practice level study | To evaluate differences in decision making quality metrics at four time points, before and after the introduction of CMR reminders |
| Harris et al 2013 [48] | 50 | Retrospective longitudinal cohort plus observational analysis | To determine differences in glycemic control and adherence to HbA1cf testing associated with SM |
| Tang et al 2013 [49] | 100 | Two-armed RCT. Online questionnaire | To evaluate an online disease management system, compared with usual car |
| Jones et al 2015 [50] | 75 | Longitudinal cohort | To describe the types and patterns of portal users in an integrated delivery system |
| Sarkar et al 2011 [51] | 75 | Survey | To examine whether social factors influence the use of a patient portal. |
| Grant et al 2008 [52] | 75 | RCT | To evaluate the impact of online access to CMR to tailor decision making support and for patient to “develop a plan of care” |
| Holbrook et al 2009 [53] | 75 | RCT | To assess the effectiveness of a shared decision support system to improve diabetes care processes & clinical markers |
| Ronda et al 2015 [54] | 75 | Survey | To examine patient experiences and use of a Web-portal to access CMR to determine the need for portal redesign |
| Ronda et al 2014 [55] | 50 | Cross sectional design/survey | To identify perceived barriers of a Web-based portal to optimize use |
| Ronda et al 2013 [56] | 75 | Survey | To examine differences and satisfaction rates of T1DMg and T2DM users or nonusers of a web portal |
| Fisher et al 2009 [57] | 75 | Focus groups and telephone interviews | To explore patients’ use of CMR, its benefits, impact, and risks |
| Jilka et al 2015 [58] |
N/Ah | Interpretative review | To evaluate the impact of a Patient accessible electronic health records for patients to manage personal clinical information |
| Bomba et al 2004 [59] | 75 | Feasibility study with field trial and focus groups | To test the feasibility of building a CMR for access using a USB stick (with unique identifier technology). To evaluate USB access |
aCMR: computerized medical records.
bRCT: randomized controlled trial.
cSMR: shared medical record.
dSM: secure messaging.
eT2DM: type 2 diabetes mellitus;
fHbA1c: glycated hemoglobin.
gT1DM: type 1 diabetes mellitus.
hN/A: not applicable.