title: VA mental health clinician experiences and attitudes toward OpenNotes.
abstract: OBJECTIVE
  To describe Department of Veterans Affairs (VA) mental health clinician attitudes toward and experiences with OpenNotes (also known as Blue Button), which provides patients direct access to clinical notes online.
  
  
  METHODS
  A 35-item online survey was administered to 263 mental health clinicians and nurses from one VA Medical Center.
  
  
  RESULTS
  Seventy-nine percent of eligible subjects participated. Most respondents agreed or somewhat agreed that OpenNotes is a good idea in general, but only half agreed that making mental health notes available online is a good idea. Most believed that patients will better remember plans of care and be better prepared for visits. Most also felt that patients will worry more and request changes in notes. Many clinicians reported being less detailed and changing the tone of their notes.
  
  
  CONCLUSIONS
  As a group, mental health clinicians are positive about OpenNotes in general but ambivalent about the use of OpenNotes in mental health care. The results call for research on outcomes of OpenNotes use in mental health and to develop education and support to help clinicians adapt to OpenNotes.
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA; Mental Health and Clinical Neurosciences Division, VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA; Department of Psychiatry, Oregon Health & Science University; 3181 Sam Jackson Park Rd, Portland, OR 97239, USA. Electronic address: Steven.Dobscha@va.gov.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Dobscha
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA; Mental Health and Clinical Neurosciences Division, VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA; Department of Psychiatry, Oregon Health & Science University; 3181 Sam Jackson Park Rd, Portland, OR 97239, USA. Electronic address: Lauren.Denneson@va.gov.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Denneson
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA. Electronic address: Laura.Jacobson1@va.gov.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Jacobson
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA. Electronic address: Holly.Williams1@va.gov.
authors.forename: Holly B
authors.initials: HB
authors.lastname: Williams
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA. Electronic address: Risa.Cromer@va.gov.
authors.forename: Risa
authors.initials: R
authors.lastname: Cromer
authors.affiliation: Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System; PO Box 1034 (R&D66), Portland, OR 97207, USA. Electronic address: Susan.Woods@va.gov.
authors.forename: Susan
authors.initials: S
authors.lastname: Woods
mesh_terms: D001291:Attitude of Health Personnel; D030881:Disclosure; D004282:Documentation; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D009722:Nurse Practitioners; D011568:Psychiatric Nursing; D011570:Psychiatry; D011584:Psychology; D012949:Social Work, Psychiatric; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: Attitude of health personnel; Electronic health records; Health services research; Mental health; Veterans