{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:14:06Z","timestamp":1788444846405,"version":"build-2803163510"},"reference-count":42,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009360","name":"King\u2019s College London","doi-asserted-by":"publisher","award":["AC20204"],"award-info":[{"award-number":["AC20204"]}],"id":[{"id":"10.13039\/100009360","id-type":"DOI","asserted-by":"publisher"}]},{"name":"King\u2019s Population Health Institute"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,24]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Epic MyChart, used as a patient portal or within Epic Healthy Planet programmes, is integrated with the Epic electronic health record system, enabling secure access to health information, communication with clinicians and self-management tools. Despite increasing portal adoption in the UK and internationally, there is fragmented and unclear evidence demonstrating impact on clinical outcomes, engagement, safety, experience, efficiency and equity. This scoping review will map existing research on Epic MyChart, identify barriers and facilitators to uptake, and explore technical and operational determinants influencing implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      We will conduct a scoping review guided by Arksey and O\u2019Malley\u2019s framework, refined by Levac\n                      <jats:italic>et al<\/jats:italic>\n                      , and report according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and PRISMA-Equity guidelines. Eligible studies will include original research evaluating Epic MyChart or Epic Healthy Planet programmes, reporting outcomes related to patient-reported measures, clinical effectiveness, engagement, safety, efficiency or equity. Searches will cover MEDLINE, CINAHL, PsycINFO, EMBASE, Cochrane CENTRAL, Scopus, trial registries and grey literature. Two reviewers will independently screen records and extract data on study characteristics, outcomes, equity factors and implementation determinants. Quantitative findings will be synthesised narratively using synthesis without meta-analysis guidance; qualitative data will undergo thematic synthesis. Stakeholder consultations with health informatics experts, clinicians, data scientists and health system managers, alongside a patient and public involvement workshop, will support interpretation of findings. A logic model will illustrate relationships between portal features, implementation factors and outcomes. Although focused on Epic MyChart, the review will offer insights relevant to other patient portals, as many implementation and equity considerations are shared across digital health systems.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required as the review uses published data. Findings will be disseminated through peer-reviewed publication, conferences and stakeholder engagement to inform implementation of patient portals internationally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      The protocol is registered on the Open Science Framework (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/osf.io\/5azdh\/overview\">https:\/\/osf.io\/5azdh\/overview<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  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Population Health Institute, King\u2019s College London, London, UK"},{"name":"Department of AI and Personalised Health, King\u2019s College London School of Life Course & Population Health Sciences, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runcong","family":"Zhao","sequence":"additional","affiliation":[{"name":"King\u2019s Population Health Institute, King\u2019s College London, London, UK"},{"name":"Department of AI and Personalised Health, King\u2019s College London School of Life Course & Population Health Sciences, London, England, UK"},{"name":"Department of Informatics, King\u2019s College London Faculty of Natural Mathematical & Engineering Sciences, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Ettefaghian","sequence":"additional","affiliation":[{"name":"Department of AI and Personalised Health, King\u2019s College London School of Life Course & Population Health Sciences, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Lafitte","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust & Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Reed","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust & Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila J","family":"Hertelendy","sequence":"additional","affiliation":[{"name":"Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, Florida, USA"},{"name":"Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien Y","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, Beijing, China"},{"name":"School of Biomedical Engineering, Tsinghua Medicine, Tsinghua University, Beijing, Beijing, China"},{"name":"Singapore Eye Research Institute, Singapore National Eye Centre, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M","family":"Sitapati","sequence":"additional","affiliation":[{"name":"Division of Biomedical Informatics, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Longhurst","sequence":"additional","affiliation":[{"name":"Division of Biomedical Informatics, University of California San Diego, La Jolla, California, 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