Patients' Interest in Reading Their Medical Record

Fowles, Jinnet B.; Kind, A; Craft, Cheryl; Kind, Elizabeth; Mandel, Jeffrey L.; Adlis, Susan A.

doi:10.1001/archinte.164.7.793

Cited by 56 publications

(11 citation statements)

References 43 publications

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“…We would call this a ''social divide.'' Similar to another study [16], women were 2.8 times more likely to access records than men. This may have to do with the observation that traditionally women tend to be more involved with their health, ask more questions, and address health concerns because they are frequently the health care decision makers in the family [16,32,33].…”

Section: Discussionsupporting

confidence: 80%

“…Emerging approaches such as patient portals, patientaccessible electronic health records (PAEHRs) [15][16][17][18][19][20][21][22], personal health records [1,9,13,23], and personally controlled health records [12,[24][25][26] (terms that are almost used interchangeably) have the potential to incent empowerment and improve resource utilization, efficiency, and patient satisfaction [9,18,[20][21][22].…”

Section: Introductionmentioning

confidence: 99%

“…It is unlikely that all consumers benefit equally or have equal interest in accessing medical records; this is dependent on other factors, such as patients' understanding of their medical condition and taking an active role in their care [5]. In a diverse patient population, it is important to understand whether ethnicity, education, socioeconomic status, or medical conditions influence patients' interest in accessing and using their medical records, and whether patient preferences should be taken into account from the start of development [8,[15][16][17][18][19][20][21]27]. Previously published studies have either surveyed patients on their perspectives regarding access to medical records without patients actually seeing what a ''medical record'' constitutes, [15][16][17][18][19][20][21]27] or were conducted in a personal health record or patient portal setting, which confounds the question of access to records with variables associated with the digital divide (computer literacy, age, and education) and is further confounded by variables associated with individual implementations [15][16][17][18][19][20][21][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patient Preferences and Perspectives on Accessing Their Medical Records

Mossaed

Leonard

Eysenbach

2015

Journal of Medical Imaging and Radiation Sciences

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patient Preferences and Perspectives on Accessing Their Medical Records

Mossaed

Leonard

Eysenbach

2015

Journal of Medical Imaging and Radiation Sciences

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“…This removes logistical barriers for patients who wish to read their mental health notes. Although patients have had the legal right to request paper copies of their medical records for some time [11], the process can be cumbersome and time-consuming, resulting in few patients typically exercising this option [12]. Furthermore, since mental health notes often contain sensitive information about patients’ mental illness, they have historically been treated differently from other progress notes, sometimes requiring clinician approval for patients to see or receive paper copies of their notes [13].…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Analysis of How Online Access to Mental Health Notes Is Changing Clinician Perceptions of Power and the Therapeutic Relationship

Denneson¹,

Cromer²,

Williams³

et al. 2017

J Med Internet Res

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BackgroundAs part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides veterans online access to their clinical progress notes, raising concern in mental health settings.ObjectiveThe aim of this study was to examine the perspectives and experiences of mental health clinicians with OpenNotes to better understand how OpenNotes may be affecting mental health care.MethodsWe conducted individual semi-structured interviews with 28 VHA mental health clinicians and nurses. Transcripts were analyzed using a thematic analysis approach, which allows for both inductive and deductive themes to be explored using an iterative, constant comparative coding process.ResultsOpenNotes is changing VHA mental health care in ways that mental health clinicians perceive as both challenging and beneficial. At the heart of these changes is a shifting power distribution within the patient-clinician relationship. Some clinicians view OpenNotes as an opportunity to better partner with patients, whereas others feel that it has the potential to undo the therapeutic relationship. Many clinicians are uncomfortable with OpenNotes, but acknowledge that this discomfort could both improve and diminish care and documentation practices. Specifically, we found that (1) OpenNotes is empowering patients, (2) OpenNotes is affecting how clinicians build and maintain the therapeutic relationship, and (3) mental health clinicians are adjusting their practices to protect patients and themselves from adverse consequences of OpenNotes.ConclusionsOur findings suggest that future research should monitor whether OpenNotes notes facilitates stronger patient-clinician relationships, enhancing patient-centered mental health care, or diminishes the quality of mental health care through disruptions in the therapeutic relationship and reduced documentation.

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“…Few people obtain copies of their records due to a lack of awareness of this option and a cumbersome process [8]. Yet many adults want full access to their records [9-11], believing access will help with self-care [12].…”

Section: Introductionmentioning

confidence: 99%

Patient Experiences With Full Electronic Access to Health Records and Clinical Notes Through the My HealtheVet Personal Health Record Pilot: Qualitative Study

Woods¹,

Schwartz²,

Tuepker³

et al. 2013

J Med Internet Res

256

189

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BackgroundFull sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports.ObjectiveA qualitative study with purposeful sampling sought to examine patients’ views and experiences with reading their health records, including their clinical notes, online.MethodsFive focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions.ResultsFour themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits.ConclusionsPatients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared records may or may not impact overall clinic workload, it is likely to change providers’ work, necessitating new types of skills to communicate and partner with patients.

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Patients' Interest in Reading Their Medical Record

Abstract: Patients' interest in reading their medical record is better predicted by their consumer approach to health care than it is by their clinical characteristics. Demographic characteristics of sex and race were related, while socioeconomic factors of education and income were not.

Cited by 56 publications

References 43 publications

Patient Preferences and Perspectives on Accessing Their Medical Records

Patient Preferences and Perspectives on Accessing Their Medical Records

A Qualitative Analysis of How Online Access to Mental Health Notes Is Changing Clinician Perceptions of Power and the Therapeutic Relationship

Patient Experiences With Full Electronic Access to Health Records and Clinical Notes Through the My HealtheVet Personal Health Record Pilot: Qualitative Study

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