4 reasons patients value access to visit notes in the EHR

There are four primary reasons patients like having access to the notes doctors and other clinicians write after a visit and include in their electronic health record, according to a new study.

With an increasing number of healthcare organizations offering patients access to their EHRs, including visit notes, via patient portals, researchers at OpenNotes and Beth Israel Deaconess Medical Center in Boston wanted to know what patients value about the process. They reported their findings in a study in the Journal of Medical Internet Research.

Researchers developed a patient feedback tool linked to the visit note in the EHR as part of a quality improvement project aimed at improving safety and learning what motivates patients to engage with their health information on the patient portal. Patients who had appointments with members of two primary care teams piloted the program.Based on 260 reports from patients and their care partners over a 12-month period, the study found 98% found the OpenNotes patient reporting tool valuable and 69% highlighted what they liked about reading the visit notes. Four themes emerged describing what patients valued about having access to visit notes:

1. Ability of patients to confirm and remember the next steps in their care. One patient in the study wrote, "I sometimes have white coat syndrome where I am a little nervous in the doctor's office and then cannot remember all that was said. Reading the notes after my visits confirms what I have heard." Many patients turned to the notes as a reminder of tests or other recommended follow-up.

2. Provides quicker access to records and results. Patients liked being able to view the information quickly and at any time. The notes, for instance, help patients understand the results of lab tests, with interpretation from health professionals about what the numbers mean.

3. Generates positive emotions. The notes help patients feel heard and gain confidence in their providers. One patient said the notes confirm that their care is being handled well.

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4. Allow sharing of information with care partners. Care partners said notes help coordinate care of their loved ones. One said reviewing the notes is especially helpful for older patients who may have hearing and cognitive problems or memory loss.

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"When experts talk about the power of health information technology, we often hear about efforts to make care more patient- and family-centered, but we've heard very little about what matters to the patients themselves, perhaps because information sharing has been largely one-way and passive," the study’s lead author, Macda Gerard, a research assistant at OpenNotes and now a first year medical student at Wayne State University in Detroit, Michigan, said an announcement.

The study also found four positives from the feedback tool: allows patients to confirm the accuracy of information and correct mistakes, creates a partnership and allows patient engagement, improves bidirectional communication and enhances education, and gives patients the opportunity to provide feedback.