Patients Evaluate Visit Notes Written by Their Clinicians: a Mixed Methods Investigation
Autor: | Zhiyong Dong, Rebecca Stametz, Steve O'Neill, Leonor Fernandez, Tom Delbanco, Sara L. Jackson, Jared W. Klein, Catherine M. DesRoches, Sigall K. Bell, Patricia Fitzgerald, Jan Walker, Suzanne G. Leveille, Kendall Harcourt |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Adolescent media_common.quotation_subject MEDLINE Specialty 01 natural sciences law.invention 03 medical and health sciences 0302 clinical medicine law Surveys and Questionnaires Perception Internal Medicine Electronic Health Records Humans Medicine Quality (business) Narrative 030212 general & internal medicine 0101 mathematics Original Research media_common business.industry 010102 general mathematics Jargon Family medicine CLARITY Willingness to recommend business |
Zdroj: | J Gen Intern Med |
ISSN: | 1525-1497 0884-8734 |
Popis: | BACKGROUND: Patients actively involved in their care demonstrate better health outcomes. Using secure internet portals, clinicians are increasingly offering patients access to their narrative visit notes (open notes), but we know little about their understanding of notes written by clinicians. OBJECTIVE: We examined patients’ views on the clarity, accuracy, and thoroughness of notes, their suggestions for improvement, and associations between their perceptions and willingness to recommend clinicians to others. DESIGN: We conducted an online survey of patients in 3 large health systems, June–October 2017. We performed a mixed methods analysis of survey responses regarding a self-selected note. PARTICIPANTS: Respondents were 21,664 patients aged 18 years or older who had read at least 1 open note in the previous 12 months. MAIN MEASURES: We asked to what degree the patient recalled understanding the note, whether it described the visit accurately, whether anything important was missing, for suggestions to improve the note, and whether they would recommend the authoring clinician to others. KEY RESULTS: Nearly all patients (96%) reported they understood all or nearly all of the self-selected note, with few differences by clinician type or specialty. Overall, 93% agreed or somewhat agreed the note accurately described the visit, and 6% reported something important missing from the note. The most common suggestions for improvement related to structure and content, jargon, and accuracy. Patients who reported understanding only some or very little of the note, or found inaccuracies or omissions, were much less likely to recommend the clinician to family and friends. CONCLUSIONS: Patients overwhelmingly report understanding their visit notes and usually find them accurate, with few disparities according to sociodemographic or health characteristics. They have many suggestions for improving their quality, and if they understand a note poorly or find inaccuracies, they often have less confidence in their clinicians. |
Databáze: | OpenAIRE |
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