The patient’s voice […] and their preferences for care and its outcomes, is too small a part of the electronic health record (EHR). If you are a researcher or innovator, collaborate with patient groups and clinicians to create new ways to capture the patient voice, and to leverage it for good.
Implementation
A patient-centered approach to writing ambulatory visit notes in the Cures Act era
Most note-writing guides to date have focused on the experience of clinicians. Here, we build on these tips by integrating patient perspectives related to note-reading.
Shared access to patient portals for older adults: Implications for privacy and digital health equity
This viewpoint article discusses challenges and opportunities of systematic engagement of care partners through shared access to the patient portal that have been amplified in the context of the COVID-19 outbreak and recent implementation of federal information blocking rules to promote information transparency alongside broader shifts toward care delivery innovation and population aging. We describe implementation considerations and the promise of granular, role-based privacy controls in addressing the nuanced and dynamic nature of individual information sharing preferences and fostering person- and family-centered care delivery.
Patient characteristics and utilization of an online patient portal in a rural academic general internal medicine practice
In a rural academic internal medicine clinic, female patients, aged 41–65, non-smokers, and those without certain chronic conditions were more likely to use an online patient portal. Recognizing and addressing barriers to patient portal use is essential for robust and sustained patient portal uptake and ensuring that the benefits of portal use are equally distributed among all patients.
The US opened up access to health records—how do patients use them?
Since April, the US has required healthcare providers to allow patients full access to their medical records—a milestone in a decades-long effort by a group of researchers and patients. Joanne Silberner examines the impact so far, and whether concerns have been borne out
Patients Contributing to Visit Notes: Mixed Methods Evaluation of OurNotes
OurNotes interests patients, and providers experience it as a positive intervention. Participation by patients, care partners, clinicians, and electronic health record experts will facilitate further development.
The 21st Century CURES Act in Pediatric Gastroenterology
The information blocking (IB) prohibition component of the 21st Century CURES Act (21CCA) comes into effect April 5, 2021, which gives patients and their families near instant access to almost all clinical notes, lab results, and health data. … A committee of pediatric gastroenterologists reviewed the 21CCA regulation and compared local practice policies. Pediatric practitioners need to understand how age will affect local information release policies and to know which note types are released, paying special consideration to trainee notes and confidential information. Extraneous detail should be removed from notes, emotional labeling be avoided, and objective statements be made when referring to the care of other providers. Awareness of the 21CCA provides pediatric gastroenterologists with the opportunity to adapt their medical documentation practices to accommodate the new law.
Open Anesthesia Records: Guidance for Anesthesia Providers on Implementing the Cures Act
Open anesthetic records may empower patients. Armed with previous anesthetic records, patients may be better prepared to communicate prior adverse events or side effects. We may also see more patients who seek the same “cocktail” of anesthetics that were provided to them in the past or may ask for the same anesthesia providers who have cared for them. Overall, patients should be able to better communicate their satisfaction or dissatisfaction with prior anesthetic experiences. Anesthesia providers will also have access to a wealth of important information, like airway management details, from prior out-of-network anesthetic records.
Healthcare in the new age of transparency
A growing body of research supports the notion that sharing transparent medical records, including clinical notes with patients, can help to strengthen communication, trust in clinicians, and patient engagement. Patients receiving dialysis may receive particular benefits from this greater transparency due to their increased risk for fragmented care. In the paper, we review the decade of research focused on the effects of sharing clinical notes with patients and the implications for improved engagement and care.
A New Chapter in Patient-Centered Care: Sharing the Medical Note?
The 21st century has ushered in a distinct emphasis on patient-centered care in allopathic medicine, as manifested by the increasing implementation of patient-centered medical homes and the frequent use of patient-centeredness in guidelines, health systems, and insurance language (1–5). The overall goal of this movement is to improve communication between physicians and patients, ultimately increasing patients’ engagement in care and improving the shared decision-making process, and thereby increasing their proclivity to follow their physicians’ advice. The costs attributed to nonadherence are staggering, estimated at $290 billion for medication nonadherence alone (6). Efforts to improve this situation are clearly warranted.
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