Shared notes enhance communication and engagement among patients, clinicians, and family members and can be an important facilitator of shared decision making. Patients report valuable clinical benefits, including improved adherence to their medications and treatment plans. Patients want transparency, and those who have experienced shared notes believe the practice should continue. Most providers who share notes want to continue the practice as well and do not report an increase in time spent writing notes.
Implementation
OpenNotes: How the power of knowing can change health care
The OpenNotes initiative is engaging patients through shared clinical notes. What have we learned since its debut, and how will open access continue to change the health care landscape?
Your Patient Is Now Reading Your Note: Opportunities, Problems, and Prospects
Patients have unprecedented online access to their medical records. More than 6 million Americans can now read their doctors’ notes via patient portals, and continued rapid growth is likely. Sharing notes with patients may yield important health benefits, including increased patient empowerment and improved medication adherence. Seeing written information, including notes, helps patients remember the plan of care, reinforces patients’ positive behaviors, and strengthens the patient–doctor alliance.
Transparenz in der Arzt-Patienten-Kommunikation
Den Patienten den Einblick in die eigenen Gesundheitsinformationen zu gewähren, kann unter anderem ihre aktive Rolle verstärken. Sie sind daran interessiert, bei der Erstellung und Bereitstellung ihrer medizinischen Aufzeichnungen beteiligt zu werden. Da sich die Transparenz im Umgang mit medizinischen Dokumenten gegenwärtig ausbreitet, ist es wichtig, ein besseres Verständnis für Vor- und Nachteile zu gewinnen. Das gilt für Patienten und Ärzte gleichermaßen. Zudem können Zielgruppen identifiziert werden, die möglicherweise unterschiedliche Formen der Übermittlung erfordern. Weitere, vertiefende Studien sind notwendig.
Health Records All Access Pass
Many healthcare organizations are striving to improve patient engagement by facilitating patient access to clinical notes in the electronic health record (EHR) via patient portals. The University of Washington Health System (UW Medicine) in Seattle, WA, was an early participant in research on patient portals as one of the three OpenNotes study sites.
Since the time of this study, the OpenNotes initiative has now grown into a national movement to improve patient engagement by granting patients the ability to view clinical notes in the EHR. Based on UW Medicine’s positive experience during the pilot study, the organization opened patient access to all clinical notes via an electronic portal throughout its entire health system.
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.
VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes
Objective To explore the experience of early patient adopters who accessed their clinical notes online using the Blue Button feature of the My HealtheVet portal.
Methods A web-based survey of VA patient portal users from June 22 to September 15, 2013.
Results 33.5% of respondents knew that clinical notes could be viewed, and nearly one in four (23.5%) said that they had viewed their notes at least once. The majority of VA Notes users agreed that accessing their notes will help them to do a better job of taking medications as prescribed (80.1%) and be better prepared for clinic visits (88.6%). Nine out of 10 users agreed that use of visit notes will help them understand their conditions better (91.8%), and better remember the plan for their care (91.9%). In contrast, 87% disagreed that VA Notes will make them worry more, and 88.4% disagreed that access to VA Notes will be more confusing than helpful. Users who had either contacted their provider or healthcare team (11.9%) or planned to (13.5%) primarily wanted to learn more about a health issue, medication, or test results (53.7%).
Conclusions Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes. These findings are congruent with OpenNotes study findings on a broader scale. Additional outreach and education is needed to enhance patient awareness. Healthcare professionals should author notes keeping in mind the opportunity patient access presents for enhanced communication.
US experience with doctors and patients sharing clinical notes
The move to offer patients online access to their clinicians’ notes is accelerating and holds promise of supporting more truly collaborative relationships between patients and clinicians, say Jan Walker, Michael Meltsner, and Tom Delbanco
For decades clinicians have experimented with making medical records available to patients.1 2 3 4 5 6 Now electronic medical records and associated secure internet portals provide patients the opportunity to view test results, medications, and other selected parts of the medical record on line.7 But few patients are offered full access to their records; clinicians’ notes are rarely visible. After a demonstration project showed the acceptability of OpenNotes (www.myopennotes.org) in the US,8 several prominent healthcare providers decided to make clinicians’ notes available to patients online before further formal evaluation. We describe the OpenNotes movement in the US and how sharing notes with patients is spreading. We also underline the case for research to assess the long term effect of sharing notes and the potential to foster improved and truly collaborative care.
Blue Button use by patients to access and share health record information using the Department of Veterans Affairs’online patient portal
Objective
The Blue Button feature of online patient portals promotes patient engagement by allowing patients to easily download their personal health information. This study examines the adoption and use of the Blue Button feature in the Department of Veterans Affairs’(VA) personal health record portal, My HealtheVet.
Materials and methods
An online survey presented to a 4% random sample of My HealtheVet users between March and May 2012. Questions were designed to determine characteristics associated with Blue Button use, perceived value of use, and how Veterans with non-VA providers use the Blue Button to share information with their non-VA providers.
The Road toward Fully Transparent Medical Records
Patients who were given access to their physicians’ notes reported having better recall and understanding of their care plans, feeling more in control of their health care, and adhering better to medication regimens. Doctors reported little effect on their work lives.
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