Introduction

Secure patient portals have improved patient access to information, including provider notes. Although there is evidence suggesting that electronic note sharing improves communication and care quality, some studies have reported provider concerns regarding note sharing.

Material and methods

This mixed-methods single site study utilized survey questions from a previously published landmark study to assess provider perceptions of electronic note sharing as well as objective EHR data. Surveys were sent to 628 providers in 34 primary and specialty care clinics approximately 12 weeks after the implementation of phase 1 (April 1, 2018) and phase 2 (July 1, 2018). EHR data were extracted from three months pre- and three months post-implementation of note sharing to determine whether or not note authoring times were affected.

Results

Nearly one-quarter (n = 150) of the responses sent to 628 providers were retained for analysis (23.9 % response rate). A majority (84.7 %) of respondents believed notes were useful vehicles for communication and 73.3 % agreed that making notes available to patients was a good idea. Additionally, 16.0 % of respondents (14.0 % for primary care and 17.0 % for specialists) believed they “spent more time writing/dictating/editing their notes.” A comparison of pre-post note authoring time revealed the aggregated primary care median increased 0.14 min (7.93–8.07 min) while aggregated specialty care median was identical (11.6 min).

Discussion

The EHR comparison of note authoring time pre-post did not reflect provider concerns identified in the survey regarding electronic note sharing.

中文翻译：

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感知与现实：与患者电子共享临床笔记时，提供者文件的行为是否会改变？

介绍

安全的患者门户网站改善了患者对信息的访问，包括提供者说明。尽管有证据表明电子便笺共享可以改善沟通和护理质量，但一些研究报告了提供者对便笺共享的担忧。

材料与方法

这项混合方法的单站点研究利用了先前发布的地标性研究中的调查问题来评估提供者对电子便笺共享以及客观EHR数据的看法。在第一阶段（2018年4月1日）和第二阶段（2018年7月1日）实施约12周后，将调查问卷发送给了34家初级和专科诊所的628名提供者。EHR数据是从笔记共享实施前三个月和实施后三个月中提取的，以确定笔记创作时间是否受到影响。

结果

发送给628个提供者的响应中有将近四分之一（n = 150）被保留以进行分析（响应率为23.9％）。大多数（84.7％）的受访者认为笔记是进行交流的有用工具，而73.3％的人认为向患者提供笔记是个好主意。此外，有16.0％的受访者（基层医疗为14.0％，专科医生为17.0％）认为他们“花了更多时间来编写/指示/编辑笔记”。事前记录撰写时间的比较显示，初级保健的总中位数增加了0.14分钟（7.93-8.07分钟），而专科护理的总中位数相同（11.6分钟）。

讨论区

EHR对便签撰写时间的比较，并未反映出提供者在调查中发现的有关电子便签共享的担忧。