Embracing the new age of transparency: mental health patients reading their psychotherapy notes online

Sharing Clinical Notes in Psychotherapy: A New Tool to Strengthen Patient Autonomy

“…Many clinicians predict that reading clinical notes might lead to widespread patient confusion (9,12,33). However, recent research suggests that when patients are invited to read their mental health notes, this can enhance the patient empowerment (7,34). Expanding on these preliminary findings, we suggest that open notes in mental health contexts may be a valuable tool to augment patient autonomy when this is understood as a relational construct.…”

“…By signaling trust in the patient as a "grownup" care partner, and by facilitating greater time to reflect on disclosures, open notes may strengthen patients' sense of agency and can conceivably play a role in improving outcomes (35). Patients express considerable interest in accessing their clinical records, including their mental health notes, and surveys suggest that only small numbers of patients are confused by what they have read (7,12,36,37). These findings are supported by qualitative research where many patients describe the enhanced levels of trust and confidence in clinicians, greater understanding about their health and treatment plans, and feelings of personal validation on reading their notes (7,(38)(39)(40).…”

“…In the USA, from November 2020, new federal rules mandate, with few exceptions, the sharing of medical notes; psychotherapy notes remain exempt from this ruling (6). Although fewer health organizations have chosen to share mental health notes (7), all patients have the right to understand their care (8). While many clinicians anticipate workflow problems from sharing notes (9, 10), studies suggest that clinicians do not experience major burdens to documentation practices (11)(12)(13).…”

The development of an epilepsy electronic patient portal: Facilitating both patient empowerment and remote clinician‐patient interaction in a post‐COVID‐19 world

“…12,13 ePortals linked to EPRs have the potential to facilitate delivery of PFCC by providing patients and their authorized care partners (eg, family members) with secure access to their health information when and where needed; clinic visit summaries, tools for patient-reported outcomes and goal setting; aids for patient education; and the means to securely message and communicate with their healthcare providers. [14][15][16][17][18] Although reports on the outcomes of ePortal mediated healthcare and services vary, there is a general faith in the promise of the technology to facilitate improved patient engagement and enable innovative models of care. [14][15][16][17][18] For example, ePortals can support delivery of virtual care, thereby obviating the need for patients to attend the clinic in person.…”

“…[14][15][16][17][18] Although reports on the outcomes of ePortal mediated healthcare and services vary, there is a general faith in the promise of the technology to facilitate improved patient engagement and enable innovative models of care. [14][15][16][17][18] For example, ePortals can support delivery of virtual care, thereby obviating the need for patients to attend the clinic in person. 1,2 Similarly, the ePortal can act as a passport of care between healthcare providers or healthcare sectors, as the patient or their care-partner will have the ability to share key clinical information as required.…”