Study: Patients much more likely to read post-visit notes when reminded by email

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Patients read a majority of their doctors’ notes when given access via email and will continue to do so if they receive periodic email reminders, according to a new study published in the Journal of the American Medical Informatics Association.

Efforts to improve the quality of healthcare are increasingly focused on giving patients more access to their medical records, including doctors’ notes following primary care visits. In 2010, physicians at Beth Israel Deaconess Medical Center (BIDMC) in Boston and Geisinger Health System (GHS) in Danville, Penn., volunteered to participate in the OpenNotes trial, in which patients were allowed to view post-visit doctors’ notes via email.

“Initial findings of the project … demonstrated considerable patient enthusiasm, improved recall of the medical plan, self-reported clinical benefits, and little impact on [primary care physician] workflow,” said lead author John Mafi, MD, and his colleagues at BIDMC. “However, while the original trial demonstrated substantial initial enthusiasm among patients, whether interest in viewing notes persists beyond the first visit or beyond the start of the trial was not known.”

To find out if patients would consistently view their doctors’ notes, Mafi and his team followed OpenNotes trial participants at BDIMC and GHS for a two-year period. Email alerts reminding patients to view the notes were discontinued at GHS after the first year, allowing the researchers to assess the overall impact of the email reminders.

They found that patients consistently read nearly 60 percent of notes at both BIDMC and GHS throughout the first year of the study, a level that was maintained along with email reminders at BIDMC in year two. At GHS, however, patients began to read fewer notes when email reminders ceased, and continued to read less of their doctors’ notes throughout the second year of the study.

“Note viewing persists when accompanied by email alerts, but may decline substantially in their absence,” the authors concluded. “As millions of patients nationwide increasingly gain access to clinicians’ notes, explicit email invitations to review notes may be important for fostering patient engagement and patient-doctor communication.”