title: Patient Access to Online Visit Notes: Perceptions of Doctors and Patients at an Urban HIV/AIDS Clinic.
abstract: Patients living with HIV/AIDS face large societal and medical challenges. Inviting patients to read their doctors' visit notes via secure electronic portals may empower patients and improve health. We investigated whether utilization and perceptions about access to doctors' notes differed among doctors and patients in an HIV/AIDS clinic versus primary care setting. We analyzed pre- and 1-year postintervention data from 99 doctors and 3819 patients. HIV clinic patients did not report differences in perceived risks and benefits compared to primary care clinic patients, however, they were more likely to share notes with friends (33% versus 9%, P=.002), other health professionals (24% versus 8%, P=.03), or another doctor (38% versus 9%, P<.0001). HIV clinic doctors were less likely than primary care doctors to change the level of candor in visit notes (P<.04). Our findings suggest that HIV clinic patients and doctors are ready to share visit notes online.
authors.affiliation: Division of General Internal Medicine, University of Washington, Seattle, WA, USA nvoster@uw.edu.
authors.forename: Natalia V
authors.initials: NV
authors.lastname: Oster
authors.affiliation: Division of General Internal Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Jackson
authors.affiliation: Division of Infectious Disease, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Shireesha
authors.initials: S
authors.lastname: Dhanireddy
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Roanne
authors.initials: R
authors.lastname: Mejilla
authors.affiliation: Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Ralston
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Leveille
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Delbanco
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Janice D
authors.initials: JD
authors.lastname: Walker
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Sigall K
authors.initials: SK
authors.lastname: Bell
authors.affiliation: Division of General Internal Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D003219:Confidentiality; D057286:Electronic Health Records; D005260:Female; D015658:HIV Infections / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D019037:Urban Health Services; D055815:Young Adult
keywords: electronic health records; health information technology; human immunodeficiency virus (HIV); personal health records; visit notes
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