Electronic Medical Record-Based Electronic Messaging Among Patients with Breast Cancer: A Systematic Review

Abstract

Background: Electronic medical record (EMR) systems and electronic messages are an increasingly common conduit between physicians and patients. Clear benefits of this type of communication have been established, especially among cancer patients. Studies suggest that patient portals and electronic messaging platforms can help with care coordination between oncology providers and facilitate asynchronous patient-provider communication. Despite the many benefits, there is little research regarding EMR and secure messaging use, particularly among patients with breast cancer.

Objectives: The objective of this systematic review was to examine the evidence supporting the use of EMR-based messaging systems in patients with breast cancer.

Methods: A systematic literature search of Ovid MEDLINE, PubMed, Scopus, Web of Science CINAHL, and Cochrane Library was conducted. Studies were required to be published between 2005 and 2022 and report data on demographic information and electronic messaging between patients and providers. Studies were excluded if they reported insufficient data, did not include breast cancer patients, or were not published in English.

Results: This study identified 10 articles that met inclusion criteria. The resulting studies investigated topics such as: patterns of messaging and medication adherence, cancer screening, messaging as a predictor of behavior or outcomes, and symptom management. The literature indicates that electronic messaging with providers was associated with clinical benefits for breast cancer patients and improved screening behaviors.

Conclusion: This review uncovered multiple areas to focus future research on, including ideal volume of electronic messages sent and their relation to prescription adherence, studies focusing solely on the breast cancer population, racial disparities in electronic messaging, and provider perceptions of electronic messaging. It is vital that more work be done to understand barriers and gaps in EMR usage to ensure that all individuals can access this increasingly essential medical service while minimizing physician workload and burnout.

Fig. 1

Literature search and selection process. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram detailing the systematic literature search of Ovid MEDLINE, PubMed, Scopus, Web of Science CINAHL, and Cochrane Library. The following search terms were used: Electronic Health Records; Health Records, Personal; Electronic Medical Record; Electronic Health Record; Computerized Medical Record; Access to information; Communication; Messaging; Health Services Accessibility; Patient Participation; Information Seeking Behavior; Neoplasms; Cancer; Malignancy; Tumor. A total of 612 articles were returned after removing duplicates. The titles and abstracts were then assessed based on inclusion and exclusion criteria by two blinded authors. Twenty-one full-text articles were assessed for eligibility. Ten studies were included in the final review.