Awareness, access are patients' greatest barriers to accessing clinical notes: 6 insights

Lack of awareness and the digital divide have been noted as leading factors that keep patients from reviewing their clinical notes, according to an April 7 Journal of the American Medical Association article.

Six insights:

1. Patients from traditionally underserved populations have been less likely to be offered access to their visit notes, and even when they have, they are less likely to read them, said Catherine DesRoches, DrPH, executive director of OpenNotes.

2. Launched in 2010 at Boston-based Beth Israel Deaconess Medical Center, OpenNotes is an international movement that supports the use of online patient portals to connect patients with their clinical notes.

3. Marlene Millen, MD, a primary care physician at University of California San Diego who uses OpenNotes, said she reminds patients at the end of a visit that they can read her notes, but most physicians don't mention it, leaving many patients unaware of the feature.

4. While more than two-thirds of Dana-Farber Cancer Institute patients have signed up for the patient portal certain patient populations haven't connected with the platform as much as others, due to various reasons such as privacy concerns and language barriers, said Nadine McCleary, MD, a gastrointestinal cancer specialist at the Boston-based health system.

5. Patients who identify as members of racial or ethnic minorities are more likely to report benefits from reading their notes but are less likely to access them, Dr. DesRoches said.

6. Under HHS' new interoperability rules patients must be able to access clinical notes via a smartphone app or other device by Oct. 6, 2022. Dr. Millen said that while some patients may not have a computer or WiFi, even most of her "older or poorer patients seem to have a smartphone," from which they can access their notes.


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