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No change in physician dictation patterns when visit notes are available online for patients

Kind, E.A. and Fowles, Jinnet B. and Craft, C.E. and Kind, A.C. and Richter, S.A. (2011) No change in physician dictation patterns when visit notes are available online for patients. Mayo Clinic Proceedings, 86 (5). pp. 397-405. ISSN 0025-6196

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    Abstract

    OBJECTIVE To determine whether physicians document office visits differently when they know their patients have easy, online access to visit notes. PATIENTS AND METHODS We conducted a natural experiment with a pre-post design and a nonrandomized control group. The setting was a multispecialty group practice in Minnesota. We reviewed a total of 400 visit notes: 100 each for patients seen in a rheumatology department (intervention group) and a pulmonary medicine department (control group) from July 1 to August 30, 2005, before online access to notes, and 100 each for patients seen in these 2 departments 1 year later, from July 1 to August 30, 2006, when only rheumatology patients had online access to visit notes. We measured changes in visit note content related to 9 hypotheses for increased patient understanding and 5 for decreased frank or judgmental language. RESULTS Changes occurred for 2 of the 9 hypotheses related to patient understanding, both in an unpredicted direction. The proportion of acronyms or abbreviations increased more in the notes of rheumatologists than of pulmonologists (0.6% vs 0.1%; P=.01), whereas the proportion of anatomy understood decreased more in the notes of rheumatologists than of pulmonologists (−5.9% vs −0.8%; P=.02). One change (of 5 possible) occurred related to the use of frank or judgmental terms. Mentions of mental health status decreased in rheumatology notes and increased in pulmonology notes (−8% vs 7%; P=.02). CONCLUSION Dictation patterns appear relatively stable over time with or without online patient access to visit notes.

    Item Type: Journal Article
    Subjects: R Medicine > R Medicine (General)
    Divisions: Office of the DVC (ARC) > Tonga Campus
    Depositing User: Ms Shalni Sanjana
    Date Deposited: 04 Jul 2011 20:33
    Last Modified: 04 Jul 2012 20:33
    URI: http://repository.usp.ac.fj/id/eprint/4887
    UNSPECIFIED

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