Patient Opinions About Electronic Health Records (EHRs)

Study reveals why patients like full access to their doctors’ visit notes

You’re struggling with a bout of back or neck pain and visit the doctor. You get your questions answered, have a treatment plan, head home, and suddenly realize you don’t remember the details of your visit. But, what if you could log in to an electronic patient portal at home that shows your doctor’s notes from the visit? Fortunately, this is a reality for millions of Americans. And, a study looked at how people are using their digital health information to boost the relationships with their doctors and their own health.
Person holding a beverage in one hand and a mobile device in the other with the display reading "E-HEALTH"A study looked at how people are using their digital health information to boost the relationships with their doctors and their own health. Photo Source: at OpenNotes, a national movement that encourages patients to read their providers’ notes online, and Beth Israel Deaconess Medical Center worked with study participants to understand what they value about having full access to their doctors’ notes and electronic health records (EHR).

The study noted that more than 15 million patients in 40 states have access to their visit notes through OpenNotes, which is housed in their clinician’s online secure patient portal.

“As OpenNotes spreads, sharing health information shows promise not only for patient engagement and adherence, but also for relational benefits such as enhanced patient trust and satisfaction,” wrote the study authors.

“Even though millions of patients can log on to patient portals to read notes, we understand little about what they value in doing so, perhaps because information sharing has been largely one-way and passive,” they said.

Passing Notes and Patient Values: “I Feel Less Helpless and Perhaps More Hopeful”
The research team developed a tool within OpenNotes that allowed patients to submit feedback about their experience reading their doctors’ notes and their EHR. Patients seeing eligible physicians between August 2014 and August 2015 could participate in the study.

The researchers received 260 feedback reports, with 98.5% of reports saying the feedback tool was valuable, and 68.8% of reports provided additional information on what patients liked about reading notes and the ability to deliver feedback.

Four themes emerged related to what patients liked about having access to their doctors’ notes:

  1. Confirm and recall next steps/follow-up action
    “For many participants, notes served as an extension of the visit,” wrote the researchers. “One patient noted: ‘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.’”
  1. Fast access and results
    “Participants found the notes particularly valuable because they provided context,” the authors said. “One patient commented: ‘I like knowing what the results of what my tests mean. The records [laboratory results] show the numbers, but the notes provide the interpretation in regard to my personal health status.’”
  1. Positive feelings
    “Reading notes helped patients gain confidence in their providers,” the authors wrote. “One patient wrote, ‘I feel less helpless and perhaps more hopeful.’”
  1. Sharing information with clinicians
    “Patients liked the option to give their notes to care partners,” the researchers said, noting the following patient feedback: “I like that I'm able to share how my visit was,” and “I can reference info[rmation] to inform my family [and/or] wife [of] what is going on.”

The researchers also found 4 additional themes regarding how the patients used notes and the feedback tool:

  1. The ability to check accuracy and note mistakes
  2. Greater sense of partnership and engagement
  3. Two-way communication between provider and patient with improved patient education
  4. Importance of feedback

More Information Access, More Engaged Patients
Health care is not a one-way street, where the patient is expected to be an observer and the provider an active participant. Patients are more engaged than ever, thanks to tools like OpenNotes that are encouraging people to understand more about their health and the rationale of their physician. The next time you see a doctor about back or neck pain, ask your provider about access to your EHR and doctor’s notes. You’re not a passive participant in your health—you’re a partner in your care.

Updated on: 12/18/18
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