Study: Patient access to visit notes aids medication adherence

The ability of patients to read the electronic health record notes that clinicians write following medical visits is very helpful for patients as they seek to better manage their medications.

That’s among the findings of a new study of about 20,000 adult patients published on Tuesday in the Annals of Internal Medicine.

The study reveals that patients who read their visit notes through online portals report feeling more comfortable with and in control of their medications, a greater understanding of medication side effects, as well as being more likely to take medications as prescribed.

In the study, three large health systems—Beth Israel Deaconess Medical Center, Geisinger and the University of Washington Medicine in Seattle—conducted a web-based survey of adult patients between June and October in 2017.

The three health systems, which have been sharing visit notes written by clinicians for several years, are part of a growing international movement among providers—called OpenNotes—designed to enhance overall safety and quality of care by ensuring the accuracy of clinician note-taking, while reducing medical errors and improving medication adherence.

Also See: UCHealth offers patients enterprise-wide access to physician notes

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“Sharing clinical notes with patients is a relatively low-cost, low-touch intervention,” said the study’s lead author Catherine DesRoches, executive director of OpenNotes and the Division of General Medicine at BIDMC. “While note sharing requires a culture shift in medicine, it is not technically difficult with most electronic health record systems and could have an enormous payoff, given that we know poor adherence to medications costs the healthcare system about $300 billion per year. Anything that we can do to improve adherence to medications has significant value.”

In the study, 64 percent of patients indicated that they had increased understanding of why a medication was prescribed; 62 percent felt more in control of their medications; 57 percent found answers to questions about medications; and 61 percent felt more comfortable with medications.

Further, 14 percent of patients at BIDMC and Geisinger reported that they were more likely to take their medications as prescribed after reading their notes, while 33 percent of patients at University of Washington said notes were very important in helping them with their medications.

“This kind of transparent communication presents a big change in long-standing practice, and it’s not easy,” said study co-author and OpenNotes co-founder Tom Delbanco, MD, the John F. Keane and Family Professor of Medicine at Harvard Medical School and BIDMC. “Doctors contemplating it for the first time are nervous. They worry about many things, including potential effects on their workflow and scaring their patients. But once they start, we know of few doctors who decide to stop, and patients overwhelmingly love it. The promise it holds for medication adherence is enormous, and we are really excited by these findings.”

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