title: VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes.
abstract: OBJECTIVE
  To explore the experience of early patient adopters who accessed their clinical notes online using the Blue Button feature of the My HealtheVet portal.
  
  
  METHODS
  A web-based survey of VA patient portal users from June 22 to September 15, 2013.
  
  
  RESULTS
  33.5% of respondents knew that clinical notes could be viewed, and nearly one in four (23.5%) said that they had viewed their notes at least once. The majority of VA Notes users agreed that accessing their notes will help them to do a better job of taking medications as prescribed (80.1%) and be better prepared for clinic visits (88.6%). Nine out of 10 users agreed that use of visit notes will help them understand their conditions better (91.8%), and better remember the plan for their care (91.9%). In contrast, 87% disagreed that VA Notes will make them worry more, and 88.4% disagreed that access to VA Notes will be more confusing than helpful. Users who had either contacted their provider or healthcare team (11.9%) or planned to (13.5%) primarily wanted to learn more about a health issue, medication, or test results (53.7%).
  
  
  CONCLUSIONS
  Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes. These findings are congruent with OpenNotes study findings on a broader scale. Additional outreach and education is needed to enhance patient awareness. Healthcare professionals should author notes keeping in mind the opportunity patient access presents for enhanced communication.
authors.affiliation: Veterans and Consumers Health Informatics Office, Office of Informatics &Analytics, Veterans Health Administration, Department of Veterans Affairs, Washington, DC, USA.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Nazi
authors.affiliation: Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, Iowa City, Iowa, USA Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Turvey
authors.affiliation: Comprehensive Access and Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, Iowa City, Iowa, USA Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Klein
authors.affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), A VA HSR&D Center of Innovation, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA National eHealth QUERI Coordinating Center, Edith Nourse Rogers Memorial Veterans Hospital, eHealth Quality Enhancement Research Initiative, Bedford, Massachusetts, USA Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hogan
authors.affiliation: VA Maine Healthcare System, Togus, Maine, USA Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Woods
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003625:Data Collection; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D033283:Patient Access to Records; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans
keywords: Open Notes; access; communication; eHealth; patient portal; veteran