Changes in Clinician Attitudes Toward Sharing Visit Notes: Surveys Pre-and Post-Implementation.

Area of Science:

• Health Services Research
• Medical Informatics
• Patient Engagement

Background:

• Clinician perceptions regarding the sharing of medical office notes with patients are not well understood.
• The implementation of open notes, allowing patients to access their clinical documentation, is a growing trend in healthcare.

Purpose of the Study:

• To evaluate changes in clinician attitudes towards sharing clinical notes with patients after the implementation of an open notes system.
• To assess clinician perceptions of the benefits and drawbacks of online access to visit notes.

Main Methods:

• A survey was conducted among outpatient primary and specialty care clinicians in a large group practice.
• Clinicians' perceptions were assessed before and after patients were invited to read their office notes (open notes).
• The primary outcome measured was the change in the percentage of clinicians who believed online visit notes were beneficial overall.

Main Results:

• Clinician agreement that online visit notes are beneficial increased from 29% to 71% (p<0.001) post-implementation.
• Concerns about increased visit duration (47% to 15%) and documentation time (57% to 28%) decreased significantly.
• However, a majority of clinicians reported maintaining less candid documentation (65% to 52%) and anticipated increased patient worry (72% to 65%).

Conclusions:

• The implementation of open notes led to a significant increase in clinician agreement regarding the overall benefit of sharing notes online.
• While practical concerns like time decreased, clinicians continued to report challenges with documentation candor and patient anxiety.
• The study highlights a positive shift in clinician perception of open notes, alongside persistent concerns about documentation and patient emotional responses.