Residents at 4 US institutions reported mixed attitudes about the anticipated effects of open clinical notes. Prior to actually sharing notes with patients, some residents perceived open notes would enhance patient education, engagement, and trust and offer unique opportunities in their own education, while residents also worried about personal workload and overwhelming patients. Most residents reported low frequency and quality of preceptor feedback on their notes. While some resident attitudes mirror faculty physician experiences, unique resident concerns merit focused attention and further research.
Crotty, Brad
Opening Residents’ Notes to Patients: A Qualitative Study of Resident and Faculty Physician Attitudes on Open Notes Implementation in Graduate Medical Education.
OpenNotes is a growing national initiative inviting patients to read clinician progress notes (open notes) through a secure electronic portal. The goals of this study were to (1) identify resident and faculty preceptor attitudes about sharing notes with patients, and (2) assess specific educational needs, policy recommendations, and approaches to facilitate open notes implementation.
Connecting Patients and Clinicians: The Anticipated Effects of Open Notes on Patient Safety and Quality of Care
The OpenNotes movement began in 2010 with the goal of fostering patient engagement in care and enhancing communication among patients, families, and clinicians. In a demonstration and evaluation study, 1 105 primary care physicians in three cities collectively invited 20,000 of their patients to read their visit notes through a secure electronic portal. After the first year, patients reported many benefits, including feeling more in control of their health, being more prepared for visits, and taking their medications with greater adherence. Physicians saw benefits with little burden, and none chose to stop participating when the pilot ended. Today, the OpenNotes movement has grown from 20,000 patients to about 5 million patients at multiple health care institutions nationwide.
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