What Do Patients Value About Reading Their Electronic Medical Record Notes?

MedicalResearch.com Interview with:
Macda Gerard
M.D. Candidate | Class of 2021
Wayne State University School of Medicine

MedicalResearch.com: What is the background for this study?

Response: As electronic health records proliferate, patients are increasingly asking for their health information but little is known about how patients use that information or whether they encounter errors in their records. This comes at a time when we’re learning that understanding the patient and family experience, especially what is most valued in exchanges between doctors and patients is important and has many benefits. To learn more, we developed a formal mechanism for patients to provide feedback on what they like about accessing the information in their health records and to inform their clinical team about things like inaccuracies and perceived errors. So that’s the gap we tried to fill.

The patient feedback tool is linked to the visit note in the electronic health record (EHR), and it’s part of a quality improvement initiative aimed at improving safety and learning what motivates patients to engage with their health information on the patient portal. Over the 12-month pilot period, 260 patients and care partners provided feedback using the OpenNotes patient feedback tool. Nearly all respondents found the tool to be valuable and about 70 percent provided additional information regarding what they liked about their notes and the feedback process.

MedicalResearch.com: What are the main findings?

Response: Overall we found that patients appreciated the ability to confirm and remember next steps, as well as the opportunity to gain quicker access to their results. Many also valued the opportunity to share information with care partners and reported that reading the notes helped them feel heard by their providers.

Many patients welcomed the opportunity to correct possible mistakes and really wanted to help providers get it right. We also found that patients valued the sense of partnership that comes with access to notes and the ability to better engage with the care team. Several also cited improved bidirectional communication and enhanced education, and many liked the simple act of being given the opportunity to provide feedback.

MedicalResearch.com: What should readers take away from your report?

  1. Providing patients with access to their visit notes and an easy way to provide feedback can be an extremely effective and low cost way to improve patient engagement and the safety of care.
  2. Patients and care partners described priorities that can be leveraged to design patient portals that better support patients and families while improving quality of care.
  3. As the pressures and needs of caregivers and family care partners of older or vulnerable patients come more clearly into focus, OpenNotes and the reporting tool can help these individuals meet the needs of the patients they support.
  4. Patients suggested that an invitation to read notes and use the reporting tool sends a message of inclusivity and empowerment, validating patients as capable change agents and promoting patient engagement
  5. OpenNotes can help shift the traditional power balance between doctors and patients, enhancing the therapeutic relationship and bringing patient and family voices more consistently to health decisions, system design and patient activation tools so that they can engage in ways that matter most to them.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Additional research and health literacy supports are needed to learn what matters most to patients and families who are not yet registered on patient portals and to make that information accessible to them in meaningful ways.

MedicalResearch.com: Is there anything else you would like to add?

Response: As a first generation Haitian-American, I’ve witnessed the struggles my family and so many others have experienced with the health care system, struggles often related to lack of access to information. I now have access to my own visit notes, and my mom reads my grandfather’s visit notes as a support person in his care. It’s tremendously rewarding for me to see my experience with note reading amplified in feedback provided by other patients and caregivers. It’s become even more clear to me that access to information is a critical element of healthcare transformation. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation: 

J Med Internet Res. 2017 Jul 14;19(7):e237. doi: 10.2196/jmir.7212.

What Patients Value About Reading Visit Notes: A Qualitative Inquiry of Patient Experiences With Their Health Information.

Gerard M1, Fossa A1, Folcarelli PH2, Walker J1, Bell SK1. 

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

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