Impacts of a web-based educational program for veterans who read their mental health notes online

Background Clinician perceptions before and after inviting patients to read office notes (open notes) are unknown. Objective To describe changes in clinicians’ attitudes about sharing notes with patients. Design, Participants, and Main Measure Survey of outpatient primary and specialty care clinicians who were from a large group practice and had one or more patients who accessed notes. The main outcome was percent change (before vs. after implementation) in clinician perception that online visit notes are beneficial overall. Key Results Of the 563 invited clinicians, 400 (71%) took the baseline survey; 295 were eligible for a follow-up survey with 192 (65%) responding (119 primary care, 47 medical specialties, 26 surgical specialties). Before implementation, 29% agreed or somewhat agreed that visit notes online are beneficial overall, increasing to 71% following implementation ( p <0.001); 44% switched beliefs from bad to good idea; and 2% reported the opposite change ( p <0.001). This post-implementation change was observed in all clinician categories. Compared to pre-implementation, fewer clinicians had concerns about office visits taking longer (47% pre vs. 15% post) or requiring more time for questions (71% vs. 16%), or producing notes (57% vs. 28%). Before and after implementation, most clinicians reported being less candid in documentation (65% vs. 52%) and that patients would have more control of their care (72% vs. 78%) and worry more (72% vs. 65%). Conclusions Following implementation, more primary and specialty care clinicians agreed that sharing notes with patients online was beneficial overall. Fewer had concerns about more time needed for office visits or documentation. Most thought patients would worry more and reported being less candid in documentation. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-06729-1.

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“… 20 , 21 Another study found these benefits could be further increased through patient education programs. 22 …”

Section: Discussionmentioning

confidence: 99%

Changes in Clinician Attitudes Toward Sharing Visit Notes: Surveys Pre-and Post-Implementation

Ralston

Penfold

et al. 2021

J GEN INTERN MED

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“…In cases in which ethics consultation notes will be made available in the patient portal, consultants can mitigate potential challenges by adapting guidance from clinicians with experience sharing notes 29,31,33,34,35 and by taking certain precautionary steps before, during, and after documentation.…”

Section: Practical Documentation Strategiesmentioning

confidence: 99%

Sharing Ethics Consultation Notes With Patients Through Online Portals

Mangino

Danis

2020

AMA Journal of Ethics

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Many health systems have adopted online patient portals that allow patients to easily view their health records. As a result, notes written by health care professionals are increasingly read by both clinicians and patients, and clinicians in specialties that routinely involve sensitive information (eg, mental health care) have had to construct notes in a manner that respectfully promotes therapeutic relationships with patients. This article discusses whether ethics consultation services should share notes with patients through online portals and ways to handle practical implementation challenges. In support of sharing notes, this article appeals to an existing right that patients have to access their health record and suggests that sharing ethics consultation notes might help patients understand key clinical ethics concepts and practices. To claim one AMA PRA Category 1 Credit TM for the CME activity associated with this article, you must do the following: (1) read this article in its entirety, (2) answer at least 80 percent of the quiz questions correctly, and (3) complete an evaluation. The quiz, evaluation, and form for claiming AMA PRA Category 1 Credit TM are available through the AMA Ed Hub TM .

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“…As an asynchronous communication tool, open notes can serve as an online extension of the visit, helping improve a sense of control and engagement with care. This may be especially important for offering reassurance to patients with long COVID whose symptoms are still poorly understood [24,25]. 6. Working under the considerable pressures wrought by the pandemic, it is not yet known whether patient safety has been negatively affected by human error [9].…”

mentioning

confidence: 99%

COVID-19 and Open Notes: A New Method to Enhance Patient Safety and Trust

Blease¹,

Salmi²,

Hägglund³

et al. 2021

JMIR Ment Health

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From April 5, 2021, as part of the 21st Century Cures Act, all providers in the United States must offer patients access to the medical information housed in their electronic records. Via secure health portals, patients can log in to access lab and test results, lists of prescribed medications, referral appointments, and the narrative reports written by clinicians (so-called open notes). As US providers implement this practice innovation, we describe six promising ways in which patients' access to their notes might help address problems that either emerged with or were exacerbated by the COVID-19 pandemic.

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Impacts of a web-based educational program for veterans who read their mental health notes online

Cited by 38 publications

References 20 publications

Changes in Clinician Attitudes Toward Sharing Visit Notes: Surveys Pre-and Post-Implementation

Changes in Clinician Attitudes Toward Sharing Visit Notes: Surveys Pre-and Post-Implementation

Sharing Ethics Consultation Notes With Patients Through Online Portals

COVID-19 and Open Notes: A New Method to Enhance Patient Safety and Trust

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