Risa Cromer1, Lauren M Denneson1, Maura Pisciotta1, Holly Williams1, Susan Woods1, Steven K Dobscha1. 1. Dr. Cromer, Dr. Denneson, Ms. Pisciotta, Ms. Williams, and Dr. Dobscha are with the Center to Improve Veteran Involvement in Care, Veterans Affairs Portland Health Care System, Portland, Oregon. Dr. Denneson and Dr. Dobscha are also with the Department of Psychiatry, Oregon Health and Science University, Portland. Dr. Woods is with the VA Connected Health Office, Veterans Affairs Maine Healthcare System, Augusta, Maine.
Abstract
OBJECTIVE: This study explored patient perspectives of how online access to clinical notes (OpenNotes) within the Veterans Affairs (VA) health care system may affect patients' relationships with their mental health clinicians. METHODS: Semistructured qualitative interviews were conducted with 28 patients receiving VA mental health care who had accessed OpenNotes. Transcripts were coded and analyzed with a constant comparative approach. RESULTS: Respondents consistently reported that patient-clinician relationships-feelings of trust in particular-are critical to the therapeutic process and that reading clinical notes strengthens or strains patients' trust in mental health clinicians. Perceptions of transparency and respect as conveyed in notes were central to maintaining trust. CONCLUSIONS: Findings suggest that ensuring consistency between what occurs during appointments and what appears in clinical notes, as well as highlighting patient individuality and strengths in notes, may help engender patient trust and avoid negative consequences of OpenNotes in mental health care.
OBJECTIVE: This study explored patient perspectives of how online access to clinical notes (OpenNotes) within the Veterans Affairs (VA) health care system may affect patients' relationships with their mental health clinicians. METHODS: Semistructured qualitative interviews were conducted with 28 patients receiving VA mental health care who had accessed OpenNotes. Transcripts were coded and analyzed with a constant comparative approach. RESULTS: Respondents consistently reported that patient-clinician relationships-feelings of trust in particular-are critical to the therapeutic process and that reading clinical notes strengthens or strains patients' trust in mental health clinicians. Perceptions of transparency and respect as conveyed in notes were central to maintaining trust. CONCLUSIONS: Findings suggest that ensuring consistency between what occurs during appointments and what appears in clinical notes, as well as highlighting patient individuality and strengths in notes, may help engender patient trust and avoid negative consequences of OpenNotes in mental health care.
Entities:
Keywords:
Electronic Health Records; Mental Health; Patient perceptions; Veterans
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