Engaging patients through open notes: an evaluation using mixed methods.

Area of Science:

• Health Informatics
• Patient Experience Research
• Digital Health

Background:

• The increasing adoption of electronic health records (EHRs) has led to initiatives like OpenNotes, allowing patients to access their clinical notes.
• Understanding patient perspectives on viewing their medical records is crucial for optimizing digital health tools and patient engagement strategies.

Purpose of the Study:

• To explore patient experiences with accessing and reviewing their doctors' visit notes.
• To assess the impact of transparent electronic medical records on quality of care, patient-doctor relationships, engagement, self-care, and clinical outcomes.

Main Methods:

• A mixed-methods qualitative study combining survey data analysis (including free-text responses) with semistructured interviews.
• Participant activation measures and member checks were employed to ensure data validity.
• The study involved patients with electronic access to their primary care physician's notes at a major medical center.

Main Results:

• Patients reported enhanced understanding of health information, improved doctor relationships, and better adherence to care plans.
• Access to notes led to increased self-care, patient-centeredness, and empowerment, with many desiring broader access.
• Patients with repeated experience reviewing notes expressed fewer concerns and perceived greater benefits.

Conclusions:

• The expansion of fully transparent medical records, like OpenNotes, shows significant potential benefits for patient activation and engagement.
• Further research is needed to understand potential harms and tailor delivery modes for diverse patient populations.
• Patients are keen on expanding note access to specialty care and actively participating in record generation.