Abstract
BackgroundWhen the Swedish version of Open Notes, an electronic health record (EHR) service that allows patients online access, was introduced in hospitals, primary care, and specialized care in 2012, psychiatric care was exempt. This was because psychiatric notes were considered too sensitive for patient access. However, as the first region in Sweden, Region Skåne added adult psychiatry to its Open Notes service in 2015. This made it possible to carry out a unique baseline study to investigate how different health care professionals (HCPs) in adult psychiatric care in the region expect Open Notes to impact their patients and their practice. This is the first of two papers about the implementation of Open Notes in adult psychiatric care in Region Skåne.ObjectiveThe objective of this study was to describe, compare, and discuss how different HCPs in adult psychiatric care in Region Skåne expect Open Notes to impact their patients and their own practice.MethodsA full population Web-based questionnaire was distributed to psychiatric care professionals in Region Skåne in late 2015. The response rate was 28.86% (871/3017). Analyses show that the respondents were representative of the staff as a whole. A statistical analysis examined the relationships between different professionals and attitudes to the Open Notes service.ResultsThe results show that the psychiatric HCPs are generally of the opinion that the service would affect their own practice and their patients negatively. The most striking result was that more than 60% of both doctors (80/132, 60.6%) and psychologists (55/90, 61%) were concerned that they would be less candid in their documentation in the future.ConclusionsOpen Notes can increase the transparency between patients and psychiatric HCPs because patients are able to access their EHRs online without delay and thus, can read notes that have not yet been approved by the responsible HCP. This may be one explanation as to why HCPs are concerned that the service will affect both their own work and their patients.
Highlights
The Development of Open Notes A discussion has surfaced recently about the effects of patients having online access to their electronic health records (EHRs; here referred to as Open Notes) in psychiatric care [1,2] and whether patients and health care professionals (HCPs) would be put at risk by the service [3]
Open Notes can increase the transparency between patients and psychiatric HCPs because patients are able to access their EHRs online without delay and can read notes that have not yet been approved by the responsible HCP
The introduction of Open Notes in psychiatry provided an opportunity for us to carry out a unique baseline study by conducting a full population survey of the employees in adult psychiatry in Region Skåne before the service became available to patients
Summary
The Development of Open Notes A discussion has surfaced recently about the effects of patients having online access to their electronic health records (EHRs; here referred to as Open Notes) in psychiatric care [1,2] and whether patients and health care professionals (HCPs) would be put at risk by the service [3]. When the Swedish version of Open Notes, an electronic health record (EHR) service that allows patients online access, was introduced in hospitals, primary care, and specialized care in 2012, psychiatric care was exempt. This was because psychiatric notes were considered too sensitive for patient access. As the first region in Sweden, Region Skåne added adult psychiatry to its Open Notes service in 2015 This made it possible to carry out a unique baseline study to investigate how different health care professionals (HCPs) in adult psychiatric care in the region expect Open Notes to impact their patients and their practice.
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