From Nov 2, 2020, new federal laws in the USA mandate that providers must extend open notes to all patients, with a few permitted exemptions. Drawing on findings in oncology settings, this paper outlines what this innovation might mean for patients and oncologists.
Patient Experience
Patients Evaluate Visit Notes Written by Their Clinicians: a Mixed Methods Investigation
Patients overwhelmingly report understanding their visit notes and usually find them accurate, with few disparities according to sociodemographic or health characteristics. They have many suggestions for improving their quality, and if they understand a note poorly or find inaccuracies, they often have less confidence in their clinicians.
Covid-19 as Innovation Accelerator: Cogenerating Telemedicine Visit Notes with Patients
Over the past decade, Beth Israel Deaconess Medical Center has been committed to sharing clinical notes with its patients. Now, as the Covid-19 pandemic is accelerating the adoption of telemedicine, the hospital’s primary care practice is implementing an initiative called OurNotes. In addition to inviting patients to review notes before and after a visit, this effort also engages patients before the telemedicine visit by soliciting important prework information through an electronic form, and by enabling coproduction of the visit note.
Embracing the new age of transparency: mental health patients reading their psychotherapy notes online
Our pilot findings indicate that most patients who read open therapy notes find them valuable for understanding and engaging in their mental health care, with minimal adverse effects.
Patients’ access to health records
The international movement pushing to increase transparency by giving patients easy access to their health information parallels a broader shift in healthcare towards increased patient empowerment and participation.
An Opportunity to Engage Obstetrics and Gynecology Patients through Shared Visit Notes
Objective: To assess obstetrics and gynecology patients’ interest in reading their ambulatory visit notes, identification of documentation errors, and perceptions of sensitive language through a quality improvement (QI) initiative.
Methods: Beginning April 2016, as part of a QI project all obstetrics and gynecology patients (except family planning) were invited to read their ambulatory visit notes and provide feedback using a patient reporting tool codeveloped with patients. Two physicians with safety expertise reviewed all patient-reported errors over the first 16 months.
Patients Managing Medications and Reading Their Visit Notes: A Survey of OpenNotes Participants
We examined patients’ perceptions of how note reading affects factors related to medication adherence. In addition, we sought to understand their engagement with online medication lists and their willingness to participate in keeping those lists correct and up to date.
OpenNotes After 7 Years: Patient Experiences With Ongoing Access to Their Clinicians’ Outpatient Visit Notes
Following a 2010-2011 pilot intervention in which a limited sample of primary care doctors offered their patients secure Web-based portal access to their office visit notes, the participating sites expanded OpenNotes to nearly all clinicians in primary care, medical, and surgical specialty practices.
Qualitative and Quantitative Analysis of Patients’ Perceptions of the Patient Portal Experience with OpenNotes
This article analyzes patients’ perceptions about the patient portal experience with access to primary care and specialist’s notes and evaluates free-text comments as an improvement opportunity.
Harnessing the Consumer Movement
In this issue, an American College of Physicians (ACP) position paper on Principles for Patient and Family Partnership in Care moves beyond longstanding rhetoric urging clinicians to become more “patient-centered” and calls for an aggressive turn toward true partnership (1). The ACP recommends that patients and families work closely with clinicians to improve medical education and health care systems. The paper cites ample evidence that such partnerships benefit patients and clinicians alike and argues that attention to dignity and respect may improve health outcomes, adherence to care plans, efficiency, and patient and clinician satisfaction.
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