J. Med. Internet Res. - Online access to doctors' notes: patient concerns about privacy.

Tópicos

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Resumo

CKGROUND: Offering patients online access to medical records, including doctors' visit notes, holds considerable potential to improve care. However, patients may worry about loss of privacy when accessing personal health information through Internet-based patient portals. The OpenNotes study provided patients at three US health care institutions with online access to their primary care doctors' notes and then collected survey data about their experiences, including their concerns about privacy before and after participation in the intervention.OBJECTIVE: To identify patients' attitudes toward privacy when given electronic access to their medical records, including visit notes.METHODS: The design used a nested cohort study of patients surveyed at baseline and after a 1-year period during which they were invited to read their visit notes through secure patient portals. Participants consisted of 3874 primary care patients from Beth Israel Deaconess Medical Center (Boston, MA), Geisinger Health System (Danville, PA), and Harborview Medical Center (Seattle, WA) who completed surveys before and after the OpenNotes intervention. The measures were patient-reported levels of concern regarding privacy associated with online access to visit notes.RESULTS: 32.91% of patients (1275/3874 respondents) reported concerns about privacy at baseline versus 36.63% (1419/3874 respondents) post-intervention. Baseline concerns were associated with non-white race/ethnicity and lower confidence in communicating with doctors, but were not associated with choosing to read notes or desire for continued online access post-intervention (nearly all patients with notes available chose to read them and wanted continued access). While the level of concern among most participants did not change during the intervention, 15.54% (602/3874 respondents, excluding participants who responded "don't know") reported more concern post-intervention, and 12.73% (493/3874 respondents, excluding participants who responded "don't know") reported less concern.CONCLUSIONS: When considering online access to visit notes, approximately one-third of patients had concerns about privacy at baseline and post-intervention. These perceptions did not deter participants from accessing their notes, suggesting that the benefits of online access to medical records may outweigh patients' perceived risks to privacy.

Resumo Limpo

ckground offer patient onlin access medic record includ doctor visit note hold consider potenti improv care howev patient may worri loss privaci access person health inform internetbas patient portal opennot studi provid patient three us health care institut onlin access primari care doctor note collect survey data experi includ concern privaci particip interventionobject identifi patient attitud toward privaci given electron access medic record includ visit notesmethod design use nest cohort studi patient survey baselin year period invit read visit note secur patient portal particip consist primari care patient beth israel deaco medic center boston ma geising health system danvill pa harborview medic center seattl wa complet survey opennot intervent measur patientreport level concern regard privaci associ onlin access visit notesresult patient respond report concern privaci baselin versus respond postintervent baselin concern associ nonwhit raceethn lower confid communic doctor associ choos read note desir continu onlin access postintervent near patient note avail chose read want continu access level concern among particip chang intervent respond exclud particip respond dont know report concern postintervent respond exclud particip respond dont know report less concernconclus consid onlin access visit note approxim onethird patient concern privaci baselin postintervent percept deter particip access note suggest benefit onlin access medic record may outweigh patient perceiv risk privaci

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