Effect of Notes' Access and Complexity on OpenNotes' Utility.

Area of Science:

• Health Informatics
• Patient Engagement
• Clinical Communication

Background:

• Healthcare providers must grant patients access to their consultation and progress notes through initiatives like OpenNotes.
• While OpenNotes shows promise in provider and patient acceptance, objective evaluations of patient interaction with notes are limited.

Purpose of the Study:

• To evaluate how note complexity and access frequency (initial vs. continuous) impact patient performance, usability, cognitive workload, and satisfaction.
• To determine the optimal conditions for patient understanding and engagement with their health records.

Main Methods:

• A 2x2 mixed-subjects experimental design was employed, varying note complexity (simple vs. complex) and access type (initial vs. continuous).
• Fifty-three participants were assessed on note comprehension, perceived usability, cognitive workload, and satisfaction using validated tools after initial and continuous access to radiation oncology notes.

Main Results:

• Patient performance in understanding notes was significantly better with simple notes and continuous access.
• Continuous access correlated positively with patient satisfaction.
• Overall perceived usability, cognitive workload, and satisfaction scores were low for both simple and complex notes.

Conclusions:

• Simplifying clinical notes enhances patient and family comprehension.
• Despite improvements, the overall usability and content of OpenNotes require substantial enhancement to improve patient and family utility.
• Further research and development are needed to optimize the design and delivery of patient-accessible health records.