A patient feedback reporting tool for OpenNotes: implications for patient-clinician safety and quality partnerships

Bell, Sigall K.; Gerard, Macda; Fossa, Alan; Delbanco, Thomas L.; Folcarelli, Patricia; Sands, Kenneth; Lee, Barbara Sarnoff; Walker, Jan

doi:10.1136/bmjqs-2016-006020

Cited by 69 publications

(103 citation statements)

References 51 publications

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“…22 Bell et al have written about the potential of OpenNotes to support patient safety and quality initiatives by the patient reporting errors and inconsistencies in the notes. 13, 23,24…”

Section: The Futurementioning

confidence: 99%

Qualitative and Quantitative Analysis of Patients' Perceptions of the Patient Portal Experience with OpenNotes

et al. 2019

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Background Access to medical encounter notes (OpenNotes) is believed to empower patients and improve the quality and safety of care. The impact of such access is not well understood beyond select health care systems and notes from primary care providers. Objectives This article analyzes patients' perceptions about the patient portal experience with access to primary care and specialist's notes and evaluates free-text comments as an improvement opportunity. Materials and Methods Patients at an academic health care system who accessed the patient portal from February 2016 to May 2016 were provided a link to complete a 15-item online survey. Those who had viewed at least one note were asked about patient characteristics, frequency of note access, note usefulness, note understanding, and if any action was taken after accessing the note. Free-text comments were associated with nine questions which were analyzed using qualitative methods. Results A total of 23% (1,487/6,439) of patients who viewed the survey in the portal, participated. Seventy-six percent (1,126/1,487) knew that the notes were available on the portal, and of those, 957 had viewed at least one note to continue the survey. Ninety percent of those were older than 30 years of age, and 90% had some college education. The majority (83%) thought OpenNotes helped them take better care of themselves, without increasing worry (94%) or contacting the physician after reading the note (91%). The qualitative analysis of free-text responses demonstrated multiple positive and negative themes, and they were analyzed for potential improvement opportunities. Conclusion Our survey confirms that patients who choose to access their primary care and specialists' online medical records perceive benefits of OpenNotes. Additionally, the qualitative analysis of comments revealed positive benefits and several potential patient portal improvement opportunities which could inform implementation of OpenNotes at other health systems.

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“…22 Bell et al have written about the potential of OpenNotes to support patient safety and quality initiatives by the patient reporting errors and inconsistencies in the notes. 13, 23,24…”

Section: The Futurementioning

confidence: 99%

Qualitative and Quantitative Analysis of Patients' Perceptions of the Patient Portal Experience with OpenNotes

et al. 2019

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“…Results from studies of adult patients in the ambulatory setting reveal that providing access to notes may help patients remember their care plan, ensure information accuracy, and feel more in control of their care. [31][32][33] However, many physicians fear that sharing their inpatient notes will result in unintended negative consequences, 34 such as disclosure of information that could lead to patient anxiety, confusion, anger, and loss of trust and privacy and/or increase litigation. These concerns are heightened in pediatrics with the complexities of protection of children and of access for adolescents.…”

Section: Discussionmentioning

confidence: 99%

Parent Perceptions of Real-time Access to Their Hospitalized Child’s Medical Records Using an Inpatient Portal: A Qualitative Study

Kelly

Thurber²,

Coller³

et al. 2019

Hospital Pediatrics

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A B S T R A C TBACKGROUND AND OBJECTIVES: Engaging with parents in care improves pediatric care quality and patient safety; however, parents of hospitalized children often lack the information necessary to effectively participate. To enhance engagement, some hospitals now provide parents with real-time online access to information from their child's inpatient medical record during hospitalization. Whether these "inpatient portals" provide benefits for parents of hospitalized children is unknown. Our objectives were to identify why parents used an inpatient portal application on a tablet computer during their child's hospitalization and identify their perspectives of ways to optimize the technology.METHODS: Semistructured in-person interviews were conducted with 14 parents who were given a tablet computer with a commercially available inpatient portal application for use throughout their child's hospitalization. The portal included vital signs, diagnoses, medications, laboratory test results, patients' schedule, messaging, education, and provider pictures and/or roles. Interviews were audio recorded and transcribed and continued until reaching thematic saturation. Three researchers used an inductive approach to identify emergent themes regarding why parents used the portal. RESULTS:Five themes emerged regarding parent motivations for accessing information within the portal: (1) monitoring progress, (2) feeling empowered and/or relying less on staff, (3) facilitating rounding communication and/or decision-making, (4) ensuring information accuracy and/or providing reassurance, and (5) aiding memory. Parents recommended that the hospital continue to offer the portal and expand it to allow parents to answer admission questions, provide feedback, and access doctors' daily notes.CONCLUSIONS: Providing parents with real-time clinical information during their child's hospitalization using an inpatient portal may enhance their ability to engage in caregiving tasks critical to ensuring inpatient care quality and safety.

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“…A wellpublicized web based instrument for reporting concerns about safety, medical error or adverse events by patients, relatives of patients and public can enable hospitals pick up patterns, and predictors that inform policies. Web based electronic information gathering from patients may result in early detection of medical errors while preserving patient doctor relationship [39,40]. In an article on the missing voice of patients in drug safety reporting Ethan Bash opined that not only should patients be able to directly report events, these entries should be evaluated and reports generated to capture subjective elements of patient safety and build confidence of patients [41].…”

Section: Discussionmentioning

confidence: 99%

A Patient Driven Approach to Patient Safety Interventions

U¹

2018

Health Care Current Reviews

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Patient safety remains an important issue within healthcare delivery in the United States. Medical errors account for about 25000 to 400000 deaths, much more morbidities and a significant cost burden each year. Despite several interventions in the last decade, rates of adverse events have been slow to change. Healthcare providers believe that patients have significant roles to play in patient safety. Patients have a positive intention to participate in patient safety interventions. However, patients' intention to participate in patient safety does not significantly align with their behavior. Most available interventions are based on empirical evidence and incompletely applied theories and models of health behavior. This resulted in inadequate outcome of a behavior change. This article seeks to present a complete health belief model as a suitable model for adopting interventions that enhance patient independence in communication to enhance patient safety. This aims also bring forward patients concerns early while preserving patient doctor relationship.

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A patient feedback reporting tool for OpenNotes: implications for patient-clinician safety and quality partnerships

Cited by 69 publications

References 51 publications

Qualitative and Quantitative Analysis of Patients' Perceptions of the Patient Portal Experience with OpenNotes

Qualitative and Quantitative Analysis of Patients' Perceptions of the Patient Portal Experience with OpenNotes

Parent Perceptions of Real-time Access to Their Hospitalized Child’s Medical Records Using an Inpatient Portal: A Qualitative Study

A Patient Driven Approach to Patient Safety Interventions

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