Background: In recent decades, there has been a worldwide shift from the traditional system of health records towards electronically managed health records. It is due to the increasing evidence of the potential of electronic health records to improve health outcomes and population health by disease prevention and better care. It necessitated the study of patients’ behavior towards online portals and their health records. Although accessible health records and online portals are intuitively appealing to improve health outcomes and enhance communication between patient and provider, little is known about the difference in patients’ preferences when they are asked to think about the relative importance of different features of health records or various functions of a hypothetical portal. It is known that ethnic minorities are less likely to adopt health information technology initiatives as compared to their majority counterparts. Knowing the behavior and preferences of all groups of society will be useful while designing an online portal. Health Information Technology tools that cater to the needs of all members of the society irrespective of race, gender, socioeconomic condition, and educational background is necessary for a just and equitable healthcare system. Such knowledge is crucial for an action-guiding anticipatory understanding of current behaviors in the adoption of online health records and the level of motivation required bringing about a behavior change.
Methods: A literature review is carried out to summarize the information on electronic health records, patient portals, and personally controlled health records. It will also shed light on International as well as the consumer’s perspective. It will briefly emphasize the impact of EHR’s on patients and their perceived barriers and facilitators of online health records adoption. Furthermore, it will also shed light on the cognitive mismatch between patient and health information technology, existing proposed theoretical frameworks on patient access to health records, their potential impact on health outcomes, barriers and facilitators in the use of health information technologies, and analysis of eHealth interventions as if they are overcoming or creating health disparities due to an unequal adoption and use. This knowledge is useful for the designs for potential e-portals to optimize the full potential of an “empowerment agenda” that would otherwise be undermined due to the “lack of engagement” of patients. Moreover, it will help ensure a just and equal healthcare system for all, including vulnerable and marginalized populations, thus, mitigating their risk of further marginalization.
Conclusion: The review will discuss the potential of eHealth initiatives to transform healthcare along with the unintended consequence of widening disparities due to unequal adoption and use. It has implications for future patient portal designs and it gives suggestions for potential portal designs to ensure engagement of all patient groups.