Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 2, 2024
Date Accepted: Oct 20, 2024
Open Note Access via Patient Portal: Insights and Trends: Retrospective Observational Study
ABSTRACT
Background:
As of 2021, at least 4/5 hospitals offered patients access to clinical notes via the online patient portal, a number expected to grow because of the 21st Century Cures Act. There is not much data on how open note usage may have evolved over time or which specialties saw the most note access in the outpatient setting.
Objective:
To study trends in open note access over time, characterize usage in terms of age, gender, and medical specialty, and assess the method of access to help uncover areas of improvement in patient engagement and identify further areas of research.
Methods:
A retrospective observational study was conducted at Erie County Medical Center for the period of November 1, 2021 to December 31, 2022 to coincide with the time that open notes went live. Outpatient note access and account logs were downloaded from the portal and combined into a single data set consisting of 18384 note accesses by 4615 users with column headings of patient index, gender, age, note title that was accessed, medical specialty, timestamp of note creation, timestamp of access, and method of access (web vs mobile). A separate table was created with gender data for all 35273 portal accounts to create a point of comparison. Microsoft Excel and Power Query were used to combine and analyze the data.
Results:
From November 1, 2021 to December 31, 2022, 4615 portal users viewed 12150 documents a total of 18384 times, averaging 2.6 notes per patient viewed 4 times. There were 1.77 females for every male accessing their note, and users in their 30s and 50s accessed more notes than other age groups. The distribution of mobile to web access of notes tended to decrease as a function of increasing age which was not observed in those aged 90+. Covid-19 assessments were the most accessed among all note categories (7476/18384). Overall, the number of users accessing notes reached a maximum of 1968 before declining to 1027 by the end of the study period.
Conclusions:
Open note access was largely dominated by Covid-19 assessments, and the number of users viewing their notes has declined over time coinciding with waning interest in the pandemic. Furthermore, females and those aged in their 30s as well as 50s viewed more notes than other groups, and web-based access of open notes remains an important modality for elderly patients. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.