Enabling family/friend caregivers with access to visit notes may help avoid errors,
delayed diagnoses, or other ambulatory safety risks. Patient, parent, and caregiver
perceptions of how shared notes affect safety behaviors and attitudes were studied
in an exploratory study.
To assess the impact of OpenNotes on safety, 24,722 patients with active portal accounts
and ≥ 1 available visit notes during the prior year at an urban hospital were surveyed
between June and September 2016. Surveys were sent to patient portal accounts, and
respondents designated themselves as patients or caregivers. Although the hospital
does not have formal proxy portal registration, some patients share access with their
Of 24,722 portal accounts accessed during the study, 7,058 (28.5%) surveys were returned,
with 150 (2.1%) participants identified as caregivers. Among patients who had tests
and referrals, reading notes helped caregivers understand the reason for the test
(96/120 [80.0%]) or referral (48/52 [92.3%]), remember to get patient tests done (66/120
[55.0%]), check (98/120 [81.7%]) and understand (98/120 [81.7%]) results, and remember
patient appointments (36/52 [69.2%]). As a result of reading notes, 54.1% (59/109)
of caregivers helping patients on prescription medications reported better assisting
patients to take them correctly. Among note-reading caregivers, 53.7% (n = 72/134) trusted the clinician more (44.8% no change), and 58.2% (n = 78/134) reported better teamwork (41.0% no change) as a result of open notes.
In total, 30.3% (n = 40/132) reported at least one mistake or possible mistake in the patient's notes.
Finding a possible mistake did not negatively affect trust or teamwork.
OpenNotes may enable caregivers with patient health information, answering the call
to better support this critical group in the health care system and to engage patients
and families in safety efforts.