Empowering patients and reducing inequities: is there potential in sharing clinical notes?

Blease, Charlotte; Fernández, Leonor; Bell, Sigall K.; Delbanco, Thomas L.; DesRoches, Catherine M.

doi:10.1136/bmjqs-2019-010490

Cited by 30 publications

(27 citation statements)

References 24 publications

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“…11 As for opportunities regarding patient empowerment, patients who read their clinical notes through online patient portals report that doing so engages them actively in their care, improves their sense of control over their health, and enhances safety, especially among minority patients. 22 Qualitative research also suggests that reading their clinical notes can help patients feel listened to, validated, and understood. 22 Open notes may increase trust between patients and clinicians, reduce transmission of biases, and increase patient engagement.…”

Section: Opportunities For Interventionmentioning

confidence: 99%

“…22 Qualitative research also suggests that reading their clinical notes can help patients feel listened to, validated, and understood. 22 Open notes may increase trust between patients and clinicians, reduce transmission of biases, and increase patient engagement. Also, patients should be given information to make informed decisions about continuing or ending a relationship with a provider; expecting mothers are not obligated to remain with a health care provider throughout a pregnancy and should be encouraged to find the right fit, particularly early in the pregnancy.…”

Section: Opportunities For Interventionmentioning

confidence: 99%

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How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States

Saluja

Bryant

2021

Journal of Women's Health

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Over the past two decades, maternal mortality rates have declined around the world. In the United States, however, 700 women die each year as a result of pregnancy or delivery complications. This represents a 50% increase in the U.S. maternal mortality rate over the same time period. According to the Centers for Disease Control and Prevention (CDC), the pregnancy-related mortality ratios vary significantly by race, with White women experiencing 13.0 deaths per 100,000 births, compared with 42.8 deaths per 100,000 births for Black women, from 2011 to 2015. Multiple studies suggest that implicit bias-defined as the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner-is most likely a contributing factor to this alarming racial health disparity. The failure to recognize the pain of African American patients, regardless of whether it is conscious or unconscious, has the potential to affect the way obstetrician/gynecologists counsel patients about treatment options when it comes to chronic conditions, contraception, vaginal birth after cesarean delivery, and the management of fibroids. In this article, we will review implicit bias and the impact it can have on health care and health disparities.

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Section: Opportunities For Interventionmentioning

confidence: 99%

Section: Opportunities For Interventionmentioning

confidence: 99%

How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States

Saluja

Bryant

2021

Journal of Women's Health

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“…63 Although research is ongoing, initial disclosures of symptoms via online patient portals may mitigate stigmatization and feelings of embarrassment in initiating conversations about mental health issues with physicians. 64 Despite patient interest and evidence of high adoption rates for health and wellness apps, there remains well documented problems with drop off rates, and how to design for continuance -issues that surveyed psychiatrists did not directly discuss. 65,66 Regulation of mHealth…”

Section: Technology and Data-collectionmentioning

confidence: 99%

Artificial intelligence and the future of psychiatry: Qualitative findings from a global physician survey

et al. 2020

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Background The potential for machine learning to disrupt the medical profession is the subject of ongoing debate within biomedical informatics. Objective This study aimed to explore psychiatrists’ opinions about the potential impact innovations in artificial intelligence and machine learning on psychiatric practice Methods In Spring 2019, we conducted a web-based survey of 791 psychiatrists from 22 countries worldwide. The survey measured opinions about the likelihood future technology would fully replace physicians in performing ten key psychiatric tasks. This study involved qualitative descriptive analysis of written responses (“comments”) to three open-ended questions in the survey. Results Comments were classified into four major categories in relation to the impact of future technology on: (1) patient-psychiatrist interactions; (2) the quality of patient medical care; (3) the profession of psychiatry; and (4) health systems. Overwhelmingly, psychiatrists were skeptical that technology could replace human empathy. Many predicted that ‘man and machine’ would increasingly collaborate in undertaking clinical decisions, with mixed opinions about the benefits and harms of such an arrangement. Participants were optimistic that technology might improve efficiencies and access to care, and reduce costs. Ethical and regulatory considerations received limited attention. Conclusions This study presents timely information on psychiatrists’ views about the scope of artificial intelligence and machine learning on psychiatric practice. Psychiatrists expressed divergent views about the value and impact of future technology with worrying omissions about practice guidelines, and ethical and regulatory issues.

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“…For example, it may be possible to list differential diagnoses in ways that are fully transparent and honest (and therefore of utility among health professionals) but also reassuring for patients. Other strategies-such as automatic annotation of notes via tooltips-might help to facilitate patient understanding of medical terminology without burdening clinician workflow (28).…”

Section: Conclusion and Recommendationsmentioning

confidence: 99%

Does Patient Access to Clinical Notes Change Documentation?

Blease

Torous

Hägglund

2020

Front. Public Health

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Empowering patients and reducing inequities: is there potential in sharing clinical notes?

Cited by 30 publications

References 24 publications

How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States

How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States

Artificial intelligence and the future of psychiatry: Qualitative findings from a global physician survey

Does Patient Access to Clinical Notes Change Documentation?

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