- Healthcare professionals regularly discuss the benefits of patient access to physician notes, stating that the transparency it provides is beneficial to improving patient engagement and patient-provider communication.
However, as the healthcare industry shifts to a patient-centric philosophy, it is important to understand not only the options for sharing health data with patients, but how patients perceive this sharing. Do patients find access to physician notes helpful? Do they really prefer having access to this information?
Below, we discuss some of the common practices for boosting patient access to physician notes, as well as some patient reactions to such practices.
Sharing physician notes helps boost patient engagement
Quantitatively, projects that advocate for the sharing of physician notes do help to improve patient engagement, and thus boost clinical outcomes, too.
In a 2013 study, researchers found that OpenNotes – a project which encourages providers to share clinical notes with patients – encouraged more than 13,000 Geisinger Health and Beth Israel Deaconess patients to access their online health data, with 80 percent of those patients reporting feeling more empowered by having access to the information. Very few patients reported feeling confused by the data.
More recently, a Geisinger Health study showed that OpenNotes improved patient engagement and, as a result, medication adherence. Patients visiting doctors who’d adopted OpenNotes were nearly 5 percent more likely to be adherent to their medications.
“Providing patients access to their doctors' notes and reminding them to read them before visiting their doctor is key to reinforcing the doctors' rationale for prescribing specific medications and dosage," said Eric A. Wright, PharmD, MPH, a research investigator at Geisinger's Center for Health Research, associate professor of pharmacy practice at Wilkes University, Wilkes-Barre, and the study's lead investigator.
These kinds of results are being felt throughout the rest of the healthcare industry, as well. In October 2015, ONC released data showing that more patients accessed their digital health data in 2014 than in 2013.
In 2014, nearly four in ten patients were offered access to their health data, and over half of them acted upon it. Approximately 80 percent of those patients found access to their health data useful. In 2013, only 46 percent of patients reported accessing their health information, but nearly the same amount found that information beneficial.
There are some downsides
Although patients report several benefits to having access to their health data, there are some downsides, particularly with regard to patient-provider communication.
The VA study showed that some patients were overwhelmed when presented with physician notes, and others said that the notes sparked some tension between the patient and provider.
“In some instances, patients expressed discomfort about the language in notes, errors or inconsistencies in note content, or strain on patient-provider dialogue,” the report’s authors wrote. “At the same time, several patients voiced contrary views, opening up discussions about pros and cons of having their information available.”
Access to health data via the patient portal also proved to sometimes cause confusion or anxiety for patients. During a 2015 study of patients receiving abnormal test results via their patient portals, eleven out of thirteen participants reported anxieties with access to their health data.
“Without prompt, eleven of the respondents spontaneously expressed concern or acknowledged the complexity of receiving abnormal test results through the portal, despite indicating it is a helpful patient tool,” researchers noted. “Some respondents were concerned about patients’ reactions to receiving abnormal test results through the portal. Concerns ranged from patient anxiety and confusion to self-harm.”
Are the benefits worth the complications?
Overall, patients do appear to like accessing their physician notes. As stated above, nearly 80 percent of patients who accessed their health data in 2014 found it beneficial. Other studies show the same.
In a 2013 study regarding the VA’s MyHealtheVet patient portal, survey respondents reported that they liked having access to clinician notes, claiming that it helped them better understand their overall health.
Benefits ranged from an increased ability to recall appointment details to increased care coordination between different providers.
“Often I get very stressed at a doctor’s appointment, don’t remember half of what’s going on and I could go on to eVet and get my information and go, ‘ok, we’re not in sync with this’…that helped a great deal,” one respondent reported.
Other patients noted that access to their health data helped them prepare for future doctor’s appointments. Being able to reference back to past appointments and knowing various health details helped patients determine what kinds of questions to ask during future appointments.
“It kind of better prepares me for the upcoming appointment, because I’ve got the data in my own hand,” another veteran said. “So, without starting out all over again, him repeating a whole lot of history, we can start a conversation at the treatment level we’re at right now.”
On the whole, patient data access seems to be a positive strategy for improving patient engagement. Going forward, providers should look into various options to expand this practice. Providers should also look into best practices for sharing these notes with their patients to ensure clarity of information and a continued positive relationship between patients and providers.