Researchers studied primary care practices that offer access to notes via a secure portal at Beth Israel Deaconess Medical Center in Boston, Harborview Medical Center in Seattle, and Geisinger Health System in Danville, Pa. The study included 105 participating physicians and 13,564 patients who had at least one completed note available during the study period. Ninety-two percent of participating patients at Geisinger opened at least one note; Beth Israel had a rate of 84 percent and Harborview followed with 47 percent.
Of nearly 5,400 patients who opened at least 1 note and completed a survey, 77 to 87 percent across the three sites reported the notes helped them feel more in control of their care, according to study authors. Sixty to 78 percent of those taking medications reported improved adherence. And 20 to 42 percent shared the note or notes with others. Twenty-six to 36 percent had privacy concerns, and 1 to 8 percent reported that the notes caused confusion, worry or offense.
Less than 10 percent of physicians reported longer visits or more time spent addressing patient questions about the notes, and up to 21 percent reported taking more time to write the notes. But survey results also showed possible conflicts that could arise from the practice of sharing notes with patients. About 60 percent of patients across the three study settings believed they should be able to add comments to the notes. And one-third believed they should be able to approve the notes, a policy that 85 to 96 percent of participating physicians did not agree with.
Study authors noted the limitations of a study involving only three geographic locations and the fact that most participants were experienced in using portals. Still, they concluded that the practice of sharing notes showed clinically relevant benefits and virtually all patients wanted the program to continue.
The study, “Inviting Patients to Read Their Doctors’ Notes: A Quasi-experimental Study and a Look Ahead,” is available here.