Letting a patient type her expectations, questions and other comments into her electronic medical record before a doctor’s appointment improves doctor-patient communication and results in more productive office visits, says a new study from the University of Washington School of Medicine.

About 100 patients attending the Adult Medicine Clinic at Harborview Medical Center in Seattle were asked recently to type their “agenda” into their online medical record to help prioritize what they wanted to see the doctor about and their expectations of what they wanted the visit to accomplish. The patients and about 28 Harborview doctors and nurses than completed a short post-visit questionnaire to evaluate the visit.

The study found that more than 80% of patients and doctors believed that patients writing down their expectations in advance helped to improve the visits. About 80% of patients also agreed that the doctors were more prepared for the visit and better understood the patient’s concerns, according to the survey.

Pre-visit electronic notes from patients ranged from “Gave my doctor my information so I wouldn’t be nervous and forget” to “Doctor and me on the same page.”  Comments from doctors in response to the survey questions included “Got time to think about issues ahead of time” and “Engaged patient to participate more in the visit, he felt heard.”

Both doctors and patients think office visits are more efficient when patients can access and write comments into OpenNotes, an electronic medical records tool that provides patients online access to doctors’ notes, says McHale Anderson, a third-year medical student at the University of Washington School of Medicine and the lead author of the study.

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“Patient participation and management of their own medical record is the next transition in medical practice throughout the country,” Anderson says. “Even though this is a small study, the findings are promising—the vast majority of the patients and doctors who participated reported quality improvements and wanted the practice to continue.”

Because many doctor office visits are time-crunched—doctors can see between 15 and 28 patients daily depending on a wide range of variables such as the size of the group practice and the physician’s specialty, according to the Centers for Disease Control—communication between patients and doctors can be strained, the report says.

But enabling patients to set the tone and communicate their expectations via notes to their electronic medical record prior to seeing the doctor did improve patient satisfaction, says University of Washington School of Medicine professor of medicine Dr. Joann Elmore.

Giving patients the ability to type comments directly into OpenNotes before an office visit also adds a new level of patient access to their electronic medical record, Elmore says.

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“These findings extend the existing OpenNotes research about patient engagement and the medical record,” Elmore says.

 

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