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Patients Who Receive Email Reminders More Likely to Read Their Doctors’ Notes, Study Finds

February 19, 2016
by Heather Landi
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Email reminders can play a key role in keeping patients engaged with their physicians’ clinical notes and their own medical records, a two-year study of 14,000 patients found.

According to a study recently published in the Journal of the American Medical Informatics Association, when patients are given electronic access to their physicians’ notes detailing their primary care visits, they are more likely to continue viewing the notes when they receive email reminders.

John Mafi, M.D., currently a professor at UCLA’s David Geffen School of Medicine, helped lead the study as a fellow at Beth Israel Deaconess Medical Center (BIDMC). Mafi and his colleagues followed OpenNotes trial participants for two years at BIDMC and Geisinger Health System (GHS) to examine whether patients invited to review their clinicians’ notes continue to assess them and to assess the impact of reminders on whether patients continued to view notes.

At GHS, electronic invitations alerting patients to their clinicians’ signed notes stopped after the first year, while the reminders continued at BIDMC, “creating a natural experiment to assess the impact of reminders,” Mafi wrote.

Researchers identified 14,360 patients and in the first year, patients viewed 57.5 percent of their notes and their interest in viewing notes persisted over time. In the second year, the study stated, BIDMC patients viewed notes with similar frequency. “In contrast, GHS patients viewed notes far less frequently, a change starting when invitations ceased and persisting to the end of the study,” Mafi wrote.

Mafi stated, “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.”

The practice of sharing visit notes more readily began with the OpenNotes yearlong pilot in 2010. At the end of a year, those who read their notes reported feeling more in control of their care and having better recall, knowledge and understanding of their medical conditions. Ninety-nine percent of patients wanted the practice to continue, and all participating doctors chose to keep their notes open after the study ended.

As previously reported by Healthcare Informatics’ Managing Editor Rajiv Leventhal, the OpenNotes movement has spread well beyond primary care to more than 5 million Americans. In the three years since the pilot results were reported, the OpenNotes movement has been adopted by major medical systems nationwide and within geographic regions, such as Oregon and southwest Washington. In December, four institutions jointly announced $10 million in new funding to continue the OpenNotes movement and spread access to clinical notes to 50 million patients nationwide.





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