Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes

Abstract

IMPORTANCE As health information transparency increases, patients more often seek their health data. More than 44 million patients in the US can now readily access their ambulatory visit notes online, and the practice is increasing abroad. Few studies have assessed documentation errors that patients identify in their notes and how these may inform patient engagement and safety strategies. OBJECTIVE To assess the frequency and types of errors identified by patients who read open ambulatory visit notes. DESIGN, SETTING, AND PARTICIPANTS In this survey study, a total of 136 815 patients at 3 US health care organizations with open notes, including 79 academic and community ambulatory care practices, received invitations to an online survey from June 5 to October 20, 2017. Patients who had at least 1 ambulatory note and had logged onto the portal at least once in the past 12 months were included. Data analysis was performed from July 3, 2018, to April 27, 2020. EXPOSURES Access to ambulatory care open notes through patient portals for up to 7 years (2010-2017). MAIN OUTCOMES AND MEASURES Proportion of patients reporting a mistake and how serious they perceived the mistake to be, factors associated with finding errors characterized by patients as serious, and categories of patient-reported errors. RESULTS Of 136 815 patients who received survey invitations, 29 656 (21.7%) responded and 22 889 patients (mean [SD] age, 55.16 [15.96] years; 14 447 [63.1%] female; 18 301 [80.0%] white) read 1 or more notes in the past 12 months and completed error questions. Of these patients, 4830 (21.1%) reported a perceived mistake and 2043 (42.3%) reported that the mistake was serious

Wearable sensor data and self-reported symptoms for COVID-19 detection

“…Our analyses are dependent entirely on participant-reported symptoms and testing results, as well as the biometric data from their personal devices. Although this is not consistent with the historically more common direct collection of information in a controlled laboratory setting or via electronic health records, previous work has confirmed their value and their accuracy beyond data routinely captured during routine care [32][33][34] . Additionally, individuals owning a smartwatch or activity tracker and having access to COVID-19 diagnostic testing are unlikely to be representative of the general population and may exclude those most affected by COVID.…”

Assessment of Patients’ Ability to Review Electronic Health Record Information to Identify Potential Errors: Cross-sectional Web-Based Survey

“…While patients with higher level of education and better health literacy may want to get more involved in their health care decision making, patients who are less educated may feel that they will not understand the information or may also feel that their doctors know what is best and be less inclined to get involved [ 33 ]. Therefore, realizing the potential of patients correcting errors in their EHRs will require broad outreach, engagement, and training for a diverse group of patients of various ages, races/ethnicities, and educational and health literacy levels [ 34 ].…”

Healthcare in the new age of transparency

“…Patients and their caregivers can and do identify clinically significant inaccuracies, omissions, and oversights in their records. In the same 2017 survey, more than 20% of patients reported an error, and more than 40% of these patients considered it “serious.” 31 Considerable research today is focusing on the patient safety implications of transparency 32 . As the practice of note sharing becomes widespread, health care organizations should have mechanisms in place to assess and correct patient‐reported errors.…”