Opening Residents’ Notes to Patients

Crotty, Bradley H.; Anselmo, Melissa; Clarke, Deserae; Famiglio, Linda M.; Flier, Lydia; Green, Jamie A.; Leveille, Suzanne G.; Mejilla, Roanne; Stametz, Rebecca; Thompson, Michelle; Walker, Jan; Bell, Sigall K.

doi:10.1097/acm.0000000000000993

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…Both groups felt that OpenNotes had the potential to empower patients but were concerned about discussing sensitive topics in the notes. Our results corroborate with a recent qualitative analysis that showed that both attending and resident physicians were concerned about offending patients and potential litigation but felt that OpenNotes could be empowering [ 5 ]. However, our results showed that resident physicians expressed significantly more discomfort than attending physicians regarding litigation, discussing obesity, and offending their patients.…”

Section: Discussionsupporting

confidence: 90%

“…As use of open clinical notes becomes more prevalent in both community and academic centers, it is imperative to evaluate perceptions of providers at all levels of training to identify barriers for comfort using OpenNotes and opportunities for education. Few studies till date have assessed internal medicine residents’ perceptions of open clinical notes and compared their perceptions with those of attending physicians [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Resident and Attending Physicians’ Perceptions of Patient Access to Provider Notes: Comparison of Perceptions Prior to Pilot Implementation

et al. 2018

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BackgroundAs electronic health records have become a more integral part of a physician’s daily life, new electronic health record tools will continue to be rolled out to trainees. Patient access to provider notes is becoming a more widespread practice because this has been shown to increase patient empowerment.ObjectiveIn this analysis, we compared differences between resident and attending physicians’ perceptions prior to implementation of patient access to provider notes to facilitate optimal use of electronic health record features and as a potential for patient empowerment.MethodsThis was a single-site study within an academic internal medicine program. Prior to implementation of patient access to provider notes, we surveyed resident and attending physicians to assess differences in perceptions of this new electronic health record tool using an open access survey provided by OpenNotes.ResultsWe surveyed 37% (20/54 total) of resident physicians and obtained a 100% response rate and 72% (31/44 total) of attending physicians. Similarities between the groups included concerns about documenting sensitive topics and anticipation of improved patient engagement. Compared with attending physicians, resident physicians were more concerned about litigation, discussing weight, offending patients, and communicated less overall with patients through electronic health record.ConclusionsPatient access to provider notes has the potential to empower patients but concerns of the resident physicians need to be validated and addressed prior to its utilization.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Resident and Attending Physicians’ Perceptions of Patient Access to Provider Notes: Comparison of Perceptions Prior to Pilot Implementation

et al. 2018

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“…The aim of this study was to explore GPs’ and advanced medical students’ perspectives and attitudes toward open health records. All barriers found in this study were reported by prior studies as well when addressing the general introduction of electronic health records [ 35 , 36 ] and when investigating physicians’ perceptions on open notes implementations [ 17 - 20 , 23 ]. Although the reluctance of physicians is a frequently reported barrier, evaluation studies of former implementation projects showed that the physicians’ initial concerns diminished after participating in pilot projects [ 2 , 19 - 21 , 37 ].…”

Section: Discussionmentioning

confidence: 74%

“…Prior research on giving patients full access to their medical records focused on implementation barriers [ 5 , 7 , 17 - 24 ]. Besides barriers such as data security or the patients’ potentially limited abilities to access and fully understand their records [ 18 , 20 , 22 , 24 ], physicians’ concerns about opening their patients’ records were recurrently described [ 18 - 21 , 23 ]. However, the reasons for physicians’ reluctance regarding such a concept remained unaddressed.…”

Section: Introductionmentioning

confidence: 99%

Beyond Known Barriers—Assessing Physician Perspectives and Attitudes Toward Introducing Open Health Records in Germany: Qualitative Study

Müller¹,

Ullrich²,

Poß-Doering³

2020

J Participat Med

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Background Giving patients access to their medical records (ie, open health records) can support doctor-patient communication and patient-centered care and can improve quality of care, patients’ health literacy, self-care, and treatment adherence. In Germany, patients are entitled by law to have access to their medical records. However, in practice doing so remains an exception in Germany. So far, research has been focused on organizational implementation barriers. Little is known about physicians’ attitudes and perspectives toward opening records in German primary care. Objective This qualitative study aims to provide a better understanding of physicians’ attitudes toward opening records in primary care in Germany. To expand the knowledge base that future implementation programs could draw from, this study focuses on professional self-conception as an influencing factor regarding the approval for open health records. Perspectives of practicing primary care physicians and advanced medical students were explored. Methods Data were collected through semistructured guide-based interviews with general practitioners (GPs) and advanced medical students. Participants were asked to share their perspectives on open health records in German general practices, as well as perceived implications, their expectations for future medical records, and the conditions for a potential implementation. Data were pseudonymized, audiotaped, and transcribed verbatim. Themes and subthemes were identified through thematic analysis. Results Barriers and potential advantages were reported by 7 GPs and 7 medical students (N=14). The following barriers were identified: (1) data security, (2) increased workload, (3) costs, (4) the patients’ limited capabilities, and (5) the physicians’ concerns. The following advantages were reported: (1) patient education and empowerment, (2) positive impact on the practice, and (3) improved quality of care. GPs’ professional self-conception influenced their approval for open records: GPs considered their aspiration for professional autonomy and freedom from external control to be threatened and their knowledge-based support of patients to be obstructed by open records. Medical students emphasized the chance to achieve shared decision making through open records and expected the implementation to be realistic in the near future. GPs were more hesitant and voiced a strong resistance toward sharing notes on perceptions that go beyond clinical data. Reliable technical conditions, the participants’ consent, and a joint development of the implementation project to meet the GPs’ interests were requested. Conclusions Open health record concepts can be seen as a chance to increase transparency in health care. For a potential future implementation in Germany, thorough consideration regarding the compatibility of GPs’ professional values would be warranted. However, the medical students’ positive attitude provides an optimistic perspective. Further research and a broad support from decision makers would be crucial to establish open records in Germany.

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“…36,42,44,47 The concerns of SCI/D providers regarding access to EHR information were similar to those voiced by some providers participating in initiatives to engage patients in reading clinical progress notes online. 48,49 Other studies, however, including some conducted in VHA, show that patients derive benefit from online access to clinical notes. 25,50 Concerns over potential liabilities associated with PHR portal use have been described in studies outside SCI/D.…”

Section: Discussionmentioning

confidence: 99%

Potential of personal health record portals in the care of individuals with spinal cord injuries and disorders: Provider perspectives

Hill

Smith

Weaver

et al. 2017

The Journal of Spinal Cord Medicine

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Opening Residents’ Notes to Patients

Cited by 22 publications

References 23 publications

Resident and Attending Physicians’ Perceptions of Patient Access to Provider Notes: Comparison of Perceptions Prior to Pilot Implementation

Resident and Attending Physicians’ Perceptions of Patient Access to Provider Notes: Comparison of Perceptions Prior to Pilot Implementation

Beyond Known Barriers—Assessing Physician Perspectives and Attitudes Toward Introducing Open Health Records in Germany: Qualitative Study

Potential of personal health record portals in the care of individuals with spinal cord injuries and disorders: Provider perspectives

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