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Deepa Rani Nandiwada, Gary S Fischer, Glenn Updike, Margaret B Conroy
BACKGROUND: As electronic health records have become a more integral part of a physician's daily life, new electronic health record tools will continue to be rolled out to trainees. Patient access to provider notes is becoming a more widespread practice because this has been shown to increase patient empowerment. OBJECTIVE: In this analysis, we compared differences between resident and attending physicians' perceptions prior to implementation of patient access to provider notes to facilitate optimal use of electronic health record features and as a potential for patient empowerment...
June 15, 2018: JMIR Medical Education
Macda Gerard, Hannah Chimowitz, Alan Fossa, Fabienne Bourgeois, Leonor Fernandez, Sigall K Bell
BACKGROUND: OpenNotes, a national initiative to share clinicians' visit notes with patients, can improve patient engagement, but effects on vulnerable populations are not known very well. OBJECTIVE: Our aim is to examine the importance of visit notes to nonwhite and less educated patients. METHODS: Patients at an urban academic medical center with an active patient portal account and ≥1 available ambulatory visit note over the prior year were surveyed during June 2016 until September 2016...
May 24, 2018: Journal of Medical Internet Research
Sigall K Bell, Patricia Folcarelli, Alan Fossa, Macda Gerard, Marvin Harper, Suzanne Leveille, Caroline Moore, Kenneth E Sands, Barbara Sarnoff Lee, Jan Walker, Fabienne Bourgeois
BACKGROUND: Ambulatory safety risks including delayed diagnoses or missed abnormal test results are difficult for clinicians to see, because they often occur in the space between visits. Experts advocate greater patient engagement to improve safety, but strategies are limited. Patient access to clinical notes ("OpenNotes") may help close the safety gap between visits. METHODS: We surveyed patients and families who logged on to the patient portal and had at least one ambulatory note available in the past 12 months at two academic hospitals during June to September 2016, focusing on patient-reported effects of OpenNotes on safety knowledge, behaviors, and attitudes...
April 27, 2018: Journal of Patient Safety
Fabienne C Bourgeois, Catherine M DesRoches, Sigall K Bell
Sharing clinic notes online with patients and parents may yield many potential benefits to patients and providers alike, but the unprecedented transparency and accessibility to notes afforded by patient portals has also raised a number of unique ethical and legal concerns. As the movement toward transparent notes (OpenNotes) grows, clinicians and health care organizations caring for pediatric and adolescent patients wrestle with how to document confidential and sensitive information, including issues such as reproductive health, misattributed paternity, or provider and parent disagreements...
May 18, 2018: Pediatrics
Jordan M Alpert, Bonny B Morris, Maria D Thomson, Khalid Matin, Charles E Geyer, Richard F Brown
Patients' ability to access their provider's clinical notes (OpenNotes) has been well received and has led to greater transparency in health systems. However, the majority of this research has occurred in primary care, and little is known about how patients' access to notes is used in oncology. This study aims to understand oncologists' perceptions of OpenNotes, while also establishing a baseline of the linguistic characteristics and patterns used in notes.Data from 13 in-depth, semistructured interviews with oncologists were thematically analyzed...
March 27, 2018: Translational Behavioral Medicine
Hannah Chimowitz, Macda Gerard, Alan Fossa, Fabienne Bourgeois, Sigall K Bell
BACKGROUND: Enabling family/friend caregivers with access to visit notes may help avoid errors, delayed diagnoses, or other ambulatory safety risks. Patient, parent, and caregiver perceptions of how shared notes affect safety behaviors and attitudes were studied in an exploratory study. METHODS: To assess the impact of OpenNotes on safety, 24,722 patients with active portal accounts and ≥ 1 available visit notes during the prior year at an urban hospital were surveyed between June and September 2016...
March 2018: Joint Commission Journal on Quality and Patient Safety
Lauren M Denneson, Jason I Chen, Maura Pisciotta, Anais Tuepker, Steven K Dobscha
OBJECTIVE: This study describes responses to OpenNotes, clinical notes available online, among patients receiving mental health care and explores whether responses vary by patient demographic or clinical characteristics. METHODS: Survey data from 178 veterans receiving mental health treatment at a large Veterans Affairs medical center included patient-reported health self-efficacy, health knowledge, alliance with clinicians, and negative emotional responses after reading OpenNotes...
May 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
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
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