More than 20% of patients say they've caught an error in EHR notes, study finds

Patient portals have helped increase patients' access to their healthcare data and clinical notes, but the tech has also shined a light on errors made in their medical records, according to a recent study published in the Journal of the American Medical Association.

For the study, a team of researchers from institutions including Boston-based Israel Deaconess Medical Center and Harvard Medical School, analyzed patient data collected from an online survey of 136,815 patients from June 5, 2017, to Oct. 20, 2017, about their use of Open Notes. The patients who participated were from three U.S. healthcare organizations that used Open Notes, which is an international movement that supports the use of online patient portals to connect patients with their clinical notes.

The data analysis was performed from July 3, 2018, to April 27, 2020, and researchers included data from patients who had at least one ambulatory note and had logged onto the patient portal at least once in the past year the survey was administered. Of the 22,889 patients analyzed, 21.1 percent reported a perceived mistake. Of those patients that reported catching an error, 42.3 percent said the mistake was serious, 32.4 percent said it was somewhat serious and 9.9 percent said it was very serious.

After categorizing the patient-reported very serious mistakes, those specifically mentioning the word "diagnosis" or describing a specific error in current or past diagnoses were most common at 27.5 percent. Other categories of errors included inaccurate medical history at 23.9 percent; medications or allergies at 14 percent; and tests, procedures or results at 8.4 percent.

The study authors concluded patients who read ambulatory notes online caught mistakes, a large portion of which they indicated as serious. However, the authors cited various study limitations, including a low response rate at 21.7 percent and some patients' lack of access to internet or data plans, patient portal or notes, indicating that true patient-reported EHR error rates could be higher or lower than reported in the study. The authors recommend implementing shared visit notes so patients are invited to report perceived errors to improve record accuracy and patient engagement in diagnosis.

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