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Lam K, Leung CH, Soomro Z, Wathoo C, Weathers SP. Perspectives from neuro-oncology providers on patient access to electronic records: a survey study. CNS Oncol 2024; 13:2352414. [PMID: 38869443 PMCID: PMC11152585 DOI: 10.1080/20450907.2024.2352414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/30/2024] [Indexed: 06/14/2024] Open
Abstract
Aim: To evaluate the neuro-oncology providers' experience with patient online access to electronic records. Methods: Cross-sectional survey for physicians and advanced care providers within the field of neuro-oncology in the USA. Results: 65 providers completed the survey, from all major regions of the USA. 58% reported that at least once per month, patients contacted them outside of an office visit about provider notes or a laboratory or imaging finding accessed online. 54% of providers did not think that all laboratory results should be released automatically, and only 25% of providers thought that all radiology reads should be released immediately. 97% thought that some patients suffered substantial distress viewing test results prior to appointments. Qualitative responses aligned with the quantitative results. Conclusion: Most neuro-oncology providers are concerned about the immediate release of laboratory and imaging findings to patients without guidance.
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Affiliation(s)
- Keng Lam
- Department of Neuro-Oncology, Unit 431, The University of Texas MD Anderson Cancer, 1400 Holcombe Blvd, Room FC7.3000, Houston, TX77030, USA
| | - Cheuk Hong Leung
- Department of Biostatistics, The University of Texas MD Anderson Cancer, 1400 Pressler St, Houston, TX77030, USA
| | - Zaid Soomro
- Department of Neuro-Oncology, Unit 431, The University of Texas MD Anderson Cancer, 1400 Holcombe Blvd, Room FC7.3000, Houston, TX77030, USA
| | - Chetna Wathoo
- Department of Neuro-Oncology, Unit 431, The University of Texas MD Anderson Cancer, 1400 Holcombe Blvd, Room FC7.3000, Houston, TX77030, USA
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, Unit 431, The University of Texas MD Anderson Cancer, 1400 Holcombe Blvd, Room FC7.3000, Houston, TX77030, USA
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Eng K, Johnston K, Cerda I, Kadakia K, Mosier-Mills A, Vanka A. A Patient-Centered Documentation Skills Curriculum for Preclerkship Medical Students in an Open Notes Era. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2024; 20:11392. [PMID: 38533390 PMCID: PMC10963659 DOI: 10.15766/mep_2374-8265.11392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/04/2024] [Indexed: 03/28/2024]
Abstract
Introduction New legislation allows patients (with permitted exceptions) to read their clinical notes, leading to both benefits and ethical dilemmas. Medical students need a robust curriculum to learn documentation skills within this challenging context. We aimed to teach note-writing skills through a patient-centered lens with special consideration for the impact on patients and providers. We developed this session for first-year medical students within their foundational clinical skills course to place bias-free language at the forefront of how they learn to construct a medical note. Methods One hundred seventy-three first-year medical and dental students participated in this curriculum. They completed an asynchronous presession module first, followed by a 2-hour synchronous workshop including a didactic, student-led discussion and sample patient note exercise. Students were subsequently responsible throughout the year for constructing patient-centered notes, graded by faculty with a newly developed rubric and checklist of best practices. Results On postworkshop surveys, learners reported increased preparedness in their ability to document in a patient-centered manner (presession M = 2.2, midyear M = 3.9, p < .001), as rated on a 5-point Likert scale (1 = not prepared at all, 5 = very prepared), and also found this topic valuable to learn early in their training. Discussion This curriculum utilizes a multipart approach to prepare learners to employ clinical notes to communicate with patients and providers, with special attention to how patients and their care partners receive a note. Future directions include expanding the curriculum to higher levels of learning and validating the developed materials.
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Affiliation(s)
- Kathleen Eng
- Fourth-Year Medical Student, Harvard Medical School
| | | | - Ivo Cerda
- Third-Year Medical Student, Harvard Medical School
| | | | | | - Anita Vanka
- Assistant Professor, Department of Medicine, Harvard Medical School
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Blease CR, Kharko A, Dong Z, Jones RB, Davidge G, Hagglund M, Turner A, DesRoches C, McMillan B. Experiences and opinions of general practitioners with patient online record access: an online survey in England. BMJ Open 2024; 14:e078158. [PMID: 38302414 PMCID: PMC10806584 DOI: 10.1136/bmjopen-2023-078158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE To describe the experiences and opinions of general practitioners (GPs) in England regarding patients having access to their full online GP health records. DESIGN Convenience sample, online survey. PARTICIPANTS 400 registered GPs in England. MAIN OUTCOME MEASURES Investigators measured GPs' experiences and opinions about online record access (ORA), including patient care and their practice. RESULTS A total of 400 GPs from all regions of England responded. A minority (130, 33%) believed ORA was a good idea. Most GPs believed a majority of patients would worry more (364, 91%) or find their GP records more confusing than helpful (338, 85%). Most GPs believed a majority of patients would find significant errors in their records (240, 60%), would better remember their care plan (280, 70%) and feel more in control of their care (243, 60%). The majority believed they will/already spend more time addressing patients' questions outside of consultations (357, 89%), that consultations will/already take significantly longer (322, 81%) and that they will be/already are less candid in their documentation (289, 72%) after ORA. Nearly two-thirds of GPs believed ORA would increase their litigation (246, 62%). CONCLUSIONS Similar to clinicians in other countries, GPs in our sample were sceptical of ORA, believing patients would worry more and find their records more confusing than helpful. Most GPs also believed the practice would exacerbate work burdens. However, the majority of GPs in this survey also agreed there were multiple benefits to patients having online access to their primary care health records. The findings of this survey also contribute to a growing body of contrastive research from countries where ORA is advanced, demonstrating clinicians are sceptical while studies indicate patients appear to derive multiple benefits.
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Affiliation(s)
- Charlotte R Blease
- Uppsala Universitet, Uppsala, Sweden
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna Kharko
- Faculty of Health, University of Plymouth, Plymouth, UK
- Department of Women and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Zhiyong Dong
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Ray B Jones
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Gail Davidge
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Maria Hagglund
- Department of Women and Children's Health, Uppsala Universitet, Uppsala, Sweden
- Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden
| | | | - Catherine DesRoches
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
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Blease C. Open AI meets open notes: surveillance capitalism, patient privacy and online record access. JOURNAL OF MEDICAL ETHICS 2024; 50:84-89. [PMID: 38050159 PMCID: PMC10850625 DOI: 10.1136/jme-2023-109574] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/30/2023] [Indexed: 12/06/2023]
Abstract
Patient online record access (ORA) is spreading worldwide, and in some countries, including Sweden, and the USA, access is advanced with patients obtaining rapid access to their full records. In the UK context, from 31 October 2023 as part of the new NHS England general practitioner (GP) contract it will be mandatory for GPs to offer ORA to patients aged 16 and older. Patients report many benefits from reading their clinical records including feeling more empowered, better understanding and remembering their treatment plan, and greater awareness about medications including possible adverse effects. However, a variety of indirect evidence suggests these benefits are unlikely to accrue without supplementation from internet-based resources. Using such routes to augment interpretation of the data and notes housed in electronic health records, however, comes with trade-offs in terms of exposing sensitive patient information to internet corporations. Furthermore, increased work burdens on clinicians, including the unique demands of ORA, combined with the easy availability and capability of a new generation of large language model (LLM)-powered chatbots, create a perfect collision course for exposing sensitive patient information to private tech companies. This paper surveys how ORA intersects with internet associated privacy risks and offers a variety of multilevel suggestions for how these risks might be better mitigated.
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Affiliation(s)
- Charlotte Blease
- Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
- Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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5
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Anyidoho PA, Verschraegen CF, Markham MJ, Alberts S, Sweetenham J, Cameron K, Abu Hejleh T. Impact of the Immediate Release of Clinical Information Rules on Health Care Delivery to Patients With Cancer. JCO Oncol Pract 2023; 19:e706-e713. [PMID: 36780583 PMCID: PMC10414766 DOI: 10.1200/op.22.00712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/20/2022] [Accepted: 01/06/2023] [Indexed: 02/15/2023] Open
Abstract
PURPOSE The 21st Century Cures Act mandates the immediate release of clinical information (IRCI) to patients. Immediate sharing of sensitive test results to patients with cancer might have serious unintended consequences for patients and providers. METHODS A 22-question REDCap survey was designed by the Association of American Cancer Institutes Physician Clinical Leadership Initiative Steering Committee to explore oncology providers' opinions on IRCI policy implementation. It was administered twice in 2021 with a 3-month interval. A third survey with a single question seeking providers' opinions about their adaptation to the IRCI mandate was administered 1 year later to those who had responded to the earlier surveys. The data were analyzed using descriptive statistics such as chi-squared or Fisher's exact tests for categorical variables. The survey was sent to all Association of American Cancer Institutes cancer center members. In the first or second administration, 167 practitioners answered the survey; 31 responded to the third survey. RESULTS Three quarters of the providers did not favor the new requirement for IRCI and 62% encountered questions from patients about results being sent to them without provider interpretation. Only half of the hospitals had a plan in place to deal with the new IRCI requirements. A third survey, for longitudinal follow-up, indicated a more favorable trend toward adoption of IRCI. CONCLUSION IRCI for patients with cancer was perceived negatively by academic oncology providers after its implementation. It was viewed to be associated with higher levels of patient anxiety and complaints about the care delivered. Providers preferred to discuss test results with patients before release.
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Affiliation(s)
- P. Abena Anyidoho
- College of Education and Human Ecology, The Ohio State University, Columbus, OH
| | | | | | | | | | - Kendra Cameron
- Association of American Cancer Institutes, Pittsburgh, PA
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Leonard SM, Zackula R, Wilcher J. Attitudes and Experiences of Clinicians After Mandated Implementation of Open Notes by the 21st Century Cures Act: Survey Study. J Med Internet Res 2023; 25:e42021. [PMID: 36853747 PMCID: PMC10015345 DOI: 10.2196/42021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND On December 13, 2016, the US Congress enacted the 21st Century Cures Act (hereafter the Cures Act), which contained the Final Rule mandate that took effect on April 5, 2021. Since then, health systems have been required to provide patients digital access to their eHealth information "without delay" and without charge. OBJECTIVE This study aimed to assess clinicians' initial experiences with, and attitudes toward, sharing visit notes with patients after being mandated to do so by the Cures Act and to determine clinician preferences regarding instant record release. METHODS This cross-sectional survey study was conducted between June 10, 2021, and August 15, 2021, at the University of Kansas Health System, a large academic medical center in Kansas City, Kansas, United States. Participants included clinicians currently employed by the health system, including resident and attending physicians, physician assistants, nurse practitioners, and critical care and emergency medicine registered nurses. RESULTS A total of 1574 attending physicians, physician assistants, and nurse practitioners, as well as 506 critical care and emergency medicine nurses, were sent invitations; 538 (34.18%) and 72 (14.2%), respectively, responded. Of 609 resident physicians, 4 (response rate not applicable because it was unknown how many residents viewed the website while the link was available) responded. The majority of respondents were attending physicians (402/614, 65.5%) and within the department of internal medicine (160/614, 26.1%). Most agreed that sharing visit notes was a good idea (355/613, 57.9%) and that it is important to speak with the patients before they accessed their records (431/613, 70.3%). Those who agreed that sharing visit notes is a good idea tended to view the practice as a useful tool for engaging patients ("Agree": 139/355, 39.2%; "Somewhat agree": 161/355, 45.4%; P<.001) and experience no change in the clinical value of their notes for other clinicians (326/355, 91.8%; P<.001). Those who disagreed (or were neutral) tended not to encourage patients to read their notes (235/258, 91.1%; P<.001) and were more likely to experience a change in their charting practice (168/257, 65.4%; P<.001) and increased time charting (99/258, 38.4%; P<.001). CONCLUSIONS The findings of this study may be generalizable to institutions similar to the University of Kansas Health System, and the clinician testimonies gathered in this study may provide valuable insight into the initial opinions and experiences of clinicians at these institutions. In addition, these clinician experiences collected early in the transition period may be used to guide future health policy implementation and to understand how best to prepare clinicians for these changes in practice.
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Affiliation(s)
- Sophia M Leonard
- Kansas City Campus, The University of Kansas School of Medicine, Kansas City, KS, United States
| | - Rosalee Zackula
- Wichita Campus, Office of Research, The University of Kansas School of Medicine, Wichita, KS, United States
| | - Jonathan Wilcher
- Kansas City Campus, Department of Emergency Medicine, The University of Kansas Health System, Kansas City, KS, United States
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Blease C, Torous J, Dong Z, Davidge G, DesRoches C, Kharko A, Turner A, Jones R, Hägglund M, McMillan B. Patient Online Record Access in English Primary Care: Qualitative Survey Study of General Practitioners' Views. J Med Internet Res 2023; 25:e43496. [PMID: 36811939 PMCID: PMC9996425 DOI: 10.2196/43496] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/16/2022] [Accepted: 12/31/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND In 2022, NHS England announced plans to ensure that all adult primary care patients in England would have full online access to new data added to their general practitioner (GP) record. However, this plan has not yet been fully implemented. Since April 2020, the GP contract in England has already committed to offering patients full online record access on a prospective basis and on request. However, there has been limited research into UK GPs' experiences and opinions about this practice innovation. OBJECTIVE This study aimed to explore the experiences and opinions of GPs in England about patients' access to their full web-based health record, including clinicians' free-text summaries of the consultation (so-called "open notes"). METHODS In March 2022, using a convenience sample, we administered a web-based mixed methods survey of 400 GPs in the United Kingdom to explore their experiences and opinions about the impact on patients and GPs' practices to offer patients full online access to their health records. Participants were recruited using the clinician marketing service Doctors.net.uk from registered GPs currently working in England. We conducted a qualitative descriptive analysis of written responses ("comments") to 4 open-ended questions embedded in a web-based questionnaire. RESULTS Of 400 GPs, 224 (56%) left comments that were classified into 4 major themes: increased strain on GP practices, the potential to harm patients, changes to documentation, and legal concerns. GPs believed that patient access would lead to extra work for them, reduced efficiency, and increased burnout. The participants also believed that access would increase patient anxiety and incur risks to patient safety. Experienced and perceived documentation changes included reduced candor and changes to record functionality. Anticipated legal concerns encompassed fears about increased litigation risks and lack of legal guidance to GPs about how to manage documentation that would be read by patients and potential third parties. CONCLUSIONS This study provides timely information on the views of GPs in England regarding patient access to their web-based health records. Overwhelmingly, GPs were skeptical about the benefits of access both for patients and to their practices. These views are similar to those expressed by clinicians in other countries, including Nordic countries and the United States before patient access. The survey was limited by the convenience sample, and it is not possible to infer that our sample was representative of the opinions of GPs in England. More extensive, qualitative research is required to understand the perspectives of patients in England after experiencing access to their web-based records. Finally, further research is needed to explore objective measures of the impact of patient access to their records on health outcomes, clinician workload, and changes to documentation.
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Affiliation(s)
- Charlotte Blease
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - John Torous
- Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Zhiyong Dong
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Gail Davidge
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom
| | - Catherine DesRoches
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Anna Kharko
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,School of Psychology, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Andrew Turner
- Centre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol, United Kingdom.,National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Ray Jones
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Maria Hägglund
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom
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DesRoches C, Walker J, Delbanco T. US experience with transparent medical records should reassure doctors. BMJ 2022; 379:o2969. [PMID: 36593551 DOI: 10.1136/bmj.o2969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Jan Walker
- Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, USA
| | - Tom Delbanco
- Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, USA
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Blease C, McMillan B, Salmi L, Davidge G, Delbanco T. Adapting to transparent medical records: international experience with "open notes". BMJ 2022; 379:e069861. [PMID: 36410770 DOI: 10.1136/bmj-2021-069861] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Charlotte Blease
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, University of Manchester, UK
| | - Liz Salmi
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Gail Davidge
- Centre for Primary Care and Health Services Research, University of Manchester, UK
| | - Tom Delbanco
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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10
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Banguilan KL, Sonnenberg F, Chen C. Physicians’ Perspectives on Inpatient Portals: A Systematic Review (Preprint). Interact J Med Res 2022; 11:e39542. [DOI: 10.2196/39542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/30/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022] Open
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Fant C, Adelman D, Zak C. Post-Cures Act: Implications for Nurse Practitioners. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Charlotte Blease
- Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - I Glenn Cohen
- Harvard Law School, Harvard University, Boston, Massachusetts
| | - Sharona Hoffman
- School of Law, Case Western Reserve University, Cleveland, Ohio
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13
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Radell JE, Tatum JN, Lin CT, Davidson RS, Pell J, Sieja A, Wu AY. Risks and rewards of increasing patient access to medical records in clinical ophthalmology using OpenNotes. Eye (Lond) 2021; 36:1951-1958. [PMID: 34611314 PMCID: PMC9500101 DOI: 10.1038/s41433-021-01775-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The implementation of OpenNotes and corresponding increase in patient access to medical records requires thorough assessment of the risks and benefits of note-sharing. Ophthalmology notes are unique among medical records in that they extensively utilize non-standardized abbreviations and drawings; they are often indecipherable even to highly-educated clinicians outside of ophthalmology. No studies to date have assessed ophthalmologist perceptions of OpenNotes. METHODS A cross-sectional study was conducted from 4/28 to 5/12/2016. A survey was distributed to 30 clinicians (25 ophthalmologists, three optometrists, two nurses) in the University of Colorado's Department of Ophthalmology to evaluate provider attitudes towards granting patients access to online medical records. RESULTS Many clinicians felt patients would have difficulty understanding their records and may be unnecessarily alarmed or offended by them. Some clinicians worried their workload would increase and feared having to change the way they document. Perceived benefits of OpenNotes included improving patient understanding of their medical conditions, strengthening patient-physician trust, and enhancing patient care. Many perceived risks and benefits of note-sharing were associated with conceptions of the ideal clinician-patient relationship. CONCLUSIONS Clinicians in ophthalmology perceived both benefits and consequences of increasing patient access to ophthalmic records, and there were significant correlations between these perceptions and their conceptions of the clinician-patient relationship. This is the first study to assess potential ophthalmology provider attitudes toward sharing ophthalmic records. Although limited in sample size and power, this study demonstrates some ways patient-accessible ophthalmic records can affect the clinical practice of ophthalmology and emphasizes the unique challenges of OpenNotes in ophthalmology.
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Affiliation(s)
- Jake E Radell
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Jasmine N Tatum
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Chen-Tan Lin
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Richard S Davidson
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jonathan Pell
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Amber Sieja
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Albert Y Wu
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
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