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Macda Gerard, Alan Fossa, Patricia H Folcarelli, Jan Walker, Sigall K Bell
BACKGROUND: Patients are increasingly asking for their health data. Yet, little is known about what motivates patients to engage with the electronic health record (EHR). Furthermore, quality-focused mechanisms for patients to comment about their records are lacking. OBJECTIVE: We aimed to learn more about patient experiences with reading and providing feedback on their visit notes. METHODS: We developed a patient feedback tool linked to OpenNotes as part of a pilot quality improvement initiative focused on patient engagement...
July 14, 2017: Journal of Medical Internet Research
Lauren M Denneson, Risa Cromer, Holly B Williams, Maura Pisciotta, Steven K Dobscha
BACKGROUND: As part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides veterans online access to their clinical progress notes, raising concern in mental health settings. OBJECTIVE: The aim of this study was to examine the perspectives and experiences of mental health clinicians with OpenNotes to better understand how OpenNotes may be affecting mental health care. METHODS: We conducted individual semi-structured interviews with 28 VHA mental health clinicians and nurses...
June 14, 2017: Journal of Medical Internet Research
Bryan S Lee, Natalia V Oster, Galen Y Chen, Leona L Ding, Janice D Walker, Joann G Elmore
PURPOSE: This study aimed to understand patients' perceptions about potential benefits and harms of accessing their own ophthalmology clinic notes via an electronic patient portal as part of the OpenNotes initiative. METHODS: The authors conducted a cross-sectional, in-person survey of ophthalmology patients at three US eye clinics. The paper survey was self-administered or administered with assistance from study staff before or after patients' clinical visits. The authors used descriptive statistics to summarise patient characteristics and patient attitudes about accessing their ophthalmology notes online...
July 2017: Ophthalmic & Physiological Optics: the Journal of the British College of Ophthalmic Opticians (Optometrists)
Risa Cromer, Lauren M Denneson, Maura Pisciotta, Holly Williams, Susan Woods, Steven K Dobscha
OBJECTIVE: This study explored patient perspectives of how online access to clinical notes (OpenNotes) within the Veterans Affairs (VA) health care system may affect patients' relationships with their mental health clinicians. METHODS: Semistructured qualitative interviews were conducted with 28 patients receiving VA mental health care who had accessed OpenNotes. Transcripts were coded and analyzed with a constant comparative approach. RESULTS: Respondents consistently reported that patient-clinician relationships-feelings of trust in particular-are critical to the therapeutic process and that reading clinical notes strengthens or strains patients' trust in mental health clinicians...
May 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
Sigall K Bell, Macda Gerard, Alan Fossa, Tom Delbanco, Patricia H Folcarelli, Kenneth E Sands, Barbara Sarnoff Lee, Jan Walker
BACKGROUND: OpenNotes, a national movement inviting patients to read their clinicians' notes online, may enhance safety through patient-reported documentation errors. OBJECTIVE: To test an OpenNotes patient reporting tool focused on safety concerns. METHODS: We invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot between August 2014 and 2015. A link at the end of the note led to a 9-question survey...
April 2017: BMJ Quality & Safety
Jennifer L Wolff, Jonathan D Darer, Andrea Berger, Deserae Clarke, Jamie A Green, Rebecca A Stametz, Tom Delbanco, Jan Walker
We examined the acceptability and effects of delivering doctors' visit notes electronically (via OpenNotes) to patients and care partners with authorized access to patients' electronic medical records. Adult patients and care partners at Geisinger Health System were surveyed at baseline and after 12 months of exposure to OpenNotes. Reporting on care partner access to OpenNotes, patients and care partners stated that they had better agreement about patient treatment plans and more productive discussions about their care...
April 1, 2017: Journal of the American Medical Informatics Association: JAMIA
Sigall K Bell, Roanne Mejilla, Melissa Anselmo, Jonathan D Darer, Joann G Elmore, Suzanne Leveille, Long Ngo, James D Ralston, Tom Delbanco, Jan Walker
BACKGROUND: Patient advocates and safety experts encourage adoption of transparent health records, but sceptics worry that shared notes may offend patients, erode trust or promote defensive medicine. As electronic health records disseminate, such disparate views fuel policy debates about risks and benefits of sharing visit notes with patients through portals. METHODS: Presurveys and postsurveys from 99 volunteer doctors at three US sites who participated in OpenNotes and postsurveys from 4592 patients who read at least one note and submitted a survey...
April 2017: BMJ Quality & Safety
John N Mafi, Roanne Mejilla, Henry Feldman, Long Ngo, Tom Delbanco, Jonathan Darer, Christina Wee, Jan Walker
OBJECTIVE: To examine whether patients invited to review their clinicians' notes continue to access them and to assess the impact of reminders on whether patients continued to view notes. MATERIALS AND METHODS: We followed OpenNotes trial participants for 2 years at Beth Israel Deaconess Medical Center (BIDMC) and Geisinger Health System (GHS). Electronic invitations alerting patients to signed notes stopped at GHS after year 1, creating a natural experiment to assess the impact of reminders...
September 2016: Journal of the American Medical Informatics Association: JAMIA
Bradley H Crotty, Melissa Anselmo, Deserae N Clarke, Linda M Famiglio, Lydia Flier, Jamie A Green, Suzanne Leveille, Roanne Mejilla, Rebecca A Stametz, Michelle Thompson, Jan Walker, Sigall K Bell
PURPOSE: 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. METHOD: This was a qualitative study using focus groups with residents and faculty physicians who supervise residents, representing primary care, general surgery, surgical and procedural specialties, and nonprocedural specialties, from Beth Israel Deaconess Medical Center and Geisinger Health System in spring 2013...
March 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Eric Wright, Jonathan Darer, Xiaoqin Tang, Jason Thompson, Lorraine Tusing, Alan Fossa, Tom Delbanco, Long Ngo, Jan Walker
BACKGROUND: In surveys, interviews, and focus groups, patients taking medications and offered Web portal access to their primary care physicians' (PCPs) notes report improved adherence to their regimens. However, objective confirmation has yet to be reported. OBJECTIVE: To evaluate the association between patient Internet portal access to primary care physician visit notes and medication adherence. METHODS: This study is a retrospective comparative analysis at one site of the OpenNotes quasi-experimental trial...
October 8, 2015: Journal of Medical Internet Research
Steven K Dobscha, Lauren M Denneson, Laura E Jacobson, Holly B Williams, Risa Cromer, Susan Woods
OBJECTIVE: To describe Department of Veterans Affairs (VA) mental health clinician attitudes toward and experiences with OpenNotes (also known as Blue Button), which provides patients direct access to clinical notes online. METHOD: A 35-item online survey was administered to 263 mental health clinicians and nurses from one VA Medical Center. RESULTS: Seventy-nine percent of eligible subjects participated. Most respondents agreed or somewhat agreed that OpenNotes is a good idea in general, but only half agreed that making mental health notes available online is a good idea...
January 2016: General Hospital Psychiatry
Kim M Nazi, Carolyn L Turvey, Dawn M Klein, Timothy P Hogan, Susan S Woods
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...
March 2015: Journal of the American Medical Informatics Association: JAMIA
Susan Trossman
No abstract text is available yet for this article.
December 2013: Oklahoma Nurse
Susan Trossman
No abstract text is available yet for this article.
September 2013: American Nurse
Elisabeth Vodicka, Roanne Mejilla, Suzanne G Leveille, James D Ralston, Jonathan D Darer, Tom Delbanco, Jan Walker, Joann G Elmore
BACKGROUND: Offering patients online access to medical records, including doctors' visit notes, holds considerable potential to improve care. However, patients may worry about loss of privacy when accessing personal health information through Internet-based patient portals. The OpenNotes study provided patients at three US health care institutions with online access to their primary care doctors' notes and then collected survey data about their experiences, including their concerns about privacy before and after participation in the intervention...
September 26, 2013: Journal of Medical Internet Research
Henry J Feldman, Janice Walker, Joseph Li, Tom Delbanco
At a time of societal fascination both with transparency and the explosion of health information technologies, a growing number of hospitals are offering, or will soon offer patients and their family instantaneous access to their doctors' and nurses' notes. What will this new opportunity for patient engagement mean for the hospitalist? Today, state and federal government regulations either encourage or require healthcare providers to grant patients access to their clinical information. But despite the rules embedded in the federal Health Insurance Portability and Accountability Act (HIPAA), patients often face time-consuming obstacles in their quest for access, and many providers view compliance as a burden...
July 2013: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Michael Meltsner
No abstract text is available yet for this article.
October 2, 2012: Annals of Internal Medicine
Suzanne G Leveille, Janice Walker, James D Ralston, Stephen E Ross, Joann G Elmore, Tom Delbanco
BACKGROUND: Providers and policymakers are pursuing strategies to increase patient engagement in health care. Increasingly, online sections of medical records are viewable by patients though seldom are clinicians' visit notes included. We designed a one-year multi-site trial of online patient accessible office visit notes, OpenNotes. We hypothesized that patients and primary care physicians (PCPs) would want it to continue and that OpenNotes would not lead to significant disruptions to doctors' practices...
2012: BMC Medical Informatics and Decision Making
Lauren Vogel
No abstract text is available yet for this article.
October 5, 2010: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Tom Delbanco, Jan Walker, Jonathan D Darer, Joann G Elmore, Henry J Feldman, Suzanne G Leveille, James D Ralston, Stephen E Ross, Elisabeth Vodicka, Valerie D Weber
Few patients read their doctors' notes, despite having the legal right to do so. As information technology makes medical records more accessible and society calls for greater transparency, patients' interest in reading their doctors' notes may increase. Inviting patients to review these notes could improve understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes. Yet, easy access to doctors' notes could have negative consequences, such as confusing or worrying patients and complicating rather than improving patient-doctor communication...
July 20, 2010: Annals of Internal Medicine
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