Thomas L. Delbanco|Jan Walker|Sigall K. Bell|Jonathan Darer|Joann G. Elmore|Nadine Farag|Hal S. Feldman|Roanne Mejilla|Long Ngo|James D. Ralston|Ross Se|Neha Trivedi|Elisabeth Vodicka|Suzanne G. Leveille
Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study and a Look Ahead
article corrected original version pdf appended article supplement chinese translation background little information exists primary care physicians pcps patients experience patients invited read doctors office notes objective evaluate effect doctors patients facilitating patient access visit notes secure internet portals design quasiexperimental trial pcps patient volunteers yearlong program provided patients electronic links doctors notes setting primary care practices beth israel deaconess medical center bidmc massachusetts geisinger health system ghs pennsylvania harborview medical center hmc washington participants 105 pcps 13 564 patients least 1 completed note available intervention period measurements portal use electronic messaging patients surveys focusing participants perceptions behaviors benefits negative consequences results 11 155 13 564 patients visit notes available opened least 1 note 84 bidmc 82 ghs 47 hmc 5219 patients opened least 1 note completed postintervention survey 77 87 across 3 sites reported open notes helped feel control care 60 78 taking medications reported increased medication adherence 26 36 privacy concerns 1 8 reported notes caused confusion worry offense 20 42 reported sharing notes others volume electronic messages patients change intervention doctors reported longer visits 0 5 time addressing patients questions outside visits 0 8 practice size little effect 3 36 doctors reported changing documentation content 0 21 reported taking time writing notes looking ahead 59 62 patients believed able add comments doctors note one 3 patients believed able approve notes contents 85 96 doctors agree end experimental period 99 patients wanted open notes continue doctor elected stop limitations 3 geographic areas represented participants experienced using portals doctors volunteering participate patients using portals completing surveys may tend offer favorable feedback response rate patient surveys 41 may limit generalizability conclusion patients accessed visit notes frequently large majority reported clinically relevant benefits minimal concerns virtually patients wanted practice continue doctors experiencing modest effect work lives open notes seem worthy widespread adoption primary funding source robert wood johnson foundation drane family fund richard florence koplow charitable foundation national cancer institute