78% of Physicians 'More Prepared' When Patients Enter EHR Notes Ahead of Appointments

Alexandra Wilson Pecci, April 4, 2017

An OpenNotes study found that letting patients type pre-visit agendas into the electronic health records system before seeing the physician made appointments more efficient and improved communication.

Joann Elmore, MD
Joann Elmore, MD

Joann Elmore, MD, MPH, professor of medicine at the University of Washington School of Medicine, is a slow typist. So slow that one of her patients grabbed the keyboard away from her while she was entering the patient's information into the electronic health record.

"Come on doc, let me type," the patient said. She and asked her Elmore what she should write. Elmore told her she should decide. It was about her, after all.

That simple idea of letting a patient contribute to the medical record in their own words is the central focus of a new study published in the Annals of Family Medicine.

Elmore is the study's lead author and research director for OpenNotes, a national movement that for more than four decades has encouraged physicians to share medical records with their patients.

In what they say is the first OpenNotes study of cogeneration of clinic notes, Elmore and her team of researchers wanted to understand the effects of having patients generate a portion of their own medical records.

They found that letting 101 patients type in pre-visit agendas before a doctor's appointment improved self-reported communication and efficiency.

The patients, all of Harborview Medical Center Adult Medicine Clinic in Seattle, WA, a safety-net facility, contributed to their notes and participated in a post-visit survey.

From June 9 and July 22, 2015, patients were either recruited via telephone the night before their appointments and asked to arrive 30 minutes early, or were approached by a receptionist if they arrived early enough.

A research assistant, third-year medical student McHale Anderson, who is also the paper's lead author, "met patients in the waiting room, provided them with a laptop computer with the clinic's [EHR/EMR] interface, and let them type their agenda," which became part of the permanent visit record, according to the study.

Alexandra Wilson Pecci

Alexandra Wilson Pecci is an editor for HealthLeaders Media.

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