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Background: Online access to computerized medical records has the potential to improve convenience, satisfaction, and care for patients, and to facilitate more efficient organization and delivery of care.Objective: The objective of this review is to explore the use and impact of having online access to computerized medical records and services for patients with type 2 diabetes mellitus in primary care.Methods: Multiple international databases including Medline, Embase, CINAHL, PsycINFO and the Cochrane Library were searched between 2004 and 2016. No limitations were placed on study design, though we applied detailed inclusion and exclusion criteria to each study. Thematic analysis was used to synthesize the evidence. The Mixed Methods Appraisal Toolkit was used to appraise study quality.Results: A search identified 917 studies, of which 28 were included. Five themes were identified: (1) disparities in uptake by age, gender, ethnicity, educational attainment, and number of comorbidities, with young men in full-time employment using these services most; (2) improved health outcomes: glycemic control was improved, but blood pressure results were mixed; (3) self-management support from improved self-care and shared management occurred especially soon after diagnosis and when complications emerged. There was a generally positive effect on physician-patient relationships; (4) accessibility: patients valued more convenient access when online access to computerized medical records and services work; and (5) technical challenges, barriers to use, and system features that impacted patient and physician use. The Mixed Methods Appraisal Toolkit rated 3 studies as 100%, 19 studies as 75%, 4 studies as 50%, and 1 study scored only 25%.Conclusions: Patients valued online access to computerized medical records and services, although in its current state of development it may increase disparities. Online access to computerized medical records appears to be safe and is associated with improved glycemic control, but there was a lack of rigorous evidence in terms of positive health outcomes for other complications, such as blood pressure. Patients remain concerned about how these systems work, the rules, and timeliness of using these systems. [ABSTRACT FROM AUTHOR]

School workers constitute the bulk of public workers in Saudi Arabia. Most of these workers seek public health care services through the Ministry of Health, which is characterised by an overloaded service. Consequently, the government is planning to introduce employment-based health insurance. However, government employees' willingness to pay (WTP) for health insurance was not investigated. This study explores the feasibility and acceptability of employment-based health insurance by examining public school workers' WTP. Methods: six hundred and twenty-second number participants from Riyadh city were interviewed from September to October 2020 using an online structured questionnaire. The contingent valuation method with a payment card was used to assess WTP among the participants. This study also determined the association between the willingness to participate and WTP for health insurance respondents' demographic and socio-economic characteristics. Chi-square and multiple linear regression analyses were used to analyse the data. The majority (76%) with an average monthly mean of 77.9 Saudi Riyal (SAR) ($20.7) per capita. Male, had higher educated, and those diagnosed with chronic disease were more likely to report a willingness to participate and/or pay for health insurance ( P > .005). This study demonstrates that WTP for employment-based health insurance depends on workers' characteristics. The results of this study may be of use to policymakers to help with a set insurance premium, priority setting and fund allocation.