Industry Insight

Survey Reveals Clinicians Support Sharing Notes With Patients

A first-of-its-kind study of the views and experiences of clinicians who have shared their notes with patients over an extended period of time was published in JAMA Network Open. Of the 1,628 doctors, advanced practice nurses, registered nurses, and others surveyed, most reported positive experiences with this new effort to offer more transparent communication, although some reported spending increased time documenting clinical visits.

The researchers conducted a web-based survey of primary care physicians, specialist physicians, advanced practice nurses, physician assistants, therapists, and others in outpatient settings at Beth Israel Deaconess Medical Center in Boston, University of Washington Medicine in Seattle, and Geisinger Health in Pennsylvania. Invitations were sent to 6,064 clinicians, and 1,628 responded to the survey. Participants were clinicians who had written at least one note that was opened by a patient in the year prior to the survey, which was administered from May 21, 2018, to August 31, 2018.

Of the 1,628 survey responses, 74% held positive views about note sharing. Thirty-seven percent of physician respondents reported spending more time in documentation, but most found the practice did not affect their workflow and would recommend it to colleagues at other institutions. Doctors with more years in practice and fewer hours spent in patient care were the most positive about open notes. Even among a subgroup of clinicians who were less enthusiastic, a majority endorsed the idea of sharing notes and believed the practice could be helpful for engaging patients more actively in their care.

“Many studies find that patients report important benefits from reading clinical notes,” says Catherine M. DesRoches, DrPH, an associate professor of medicine at Beth Israel Deaconess Medical Center and Harvard Medical School, and lead author of the study. “However, this practice is relatively new, and we wanted to understand the long-term impact on doctors and other clinicians. Our findings that most clinicians are positive about sharing notes should be reassuring to health care organizations as they work to offer greater transparency to their patients.”

Doctors reported changing the way they composed their notes, including both how they document sensitive information and guard against language that might be perceived as critical of patients. Female doctors were more likely than males to report making changes to their notes and spending more time in documentation.

This study may help clinicians prepare for rapidly evolving changes in practice. Passed by Congress in 2016, the 21st Century Cures Act requires patients be given electronic access to virtually all the information in their EMRs. Final rules designed to implement the 21st Century Cures Act include a provision requiring that patients can electronically access all of their electronic health information at no cost, including the notes their clinicians write.

“We’ve learned over the past 10 years that truly transparent communication brings enormous clinical benefits to patients,” says Tom Delbanco, MD, the John F. Keane & Family Professor of Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School, and cofounder of the international OpenNotes movement, and cosenior author of the study. “It helps them manage medications more effectively, and it builds trust and patient safety. We started small, but today 45 million patients in the US have gained ready access to notes their doctors are writing.”

— Source: Beth Israel Deaconess Medical Center

Netsmart Expands Coding and Billing Service Offerings With Acquisition of QIRT

Netsmart announces it has acquired New York–based postacute health care consulting firm, Quality In Real Time (QIRT). Together, Netsmart and QIRT offerings will form the largest service provider in the postacute community.

QIRT will become part of the McBee strategic consulting business unit to expand McBee’s OASIS, minimum data set (MDS) coding and advisory consulting services for postacute care and behavioral health providers. This acquisition builds upon the current Netsmart suite of operational, financial, and clinical services by leveraging additional QIRT offerings, such as MDS and uniform assessment system reviews.

“Netsmart and QIRT have a mutual dedication to quality of services and products. This commonality of values will further scale the Netsmart services offering to support and help postacute agencies thrive. This partnership also brings together the top two OASIS and coding providers to serve the postacute community,” says Netsmart CEO Mike Valentine. “The merger of QIRT with McBee will provide the resources needed to allow Netsmart to deliver increased value to clients and will provide the opportunity for QIRT’s clients to leverage other Netsmart solutions and services.”

— Source: Netsmart

AHIOS Names Rita Bowen to Leadership Committee

The Association of Health Information Outsourcing Services (AHIOS), an organization of executives from HIM outsourcing companies who promote excellence in managing risk and compliance issues around the disclosure of protected health information, announces that Rita Bowen, MA, RHIA, CHPS, CHPC, SSGB, will join the association’s leadership committee as legislative and government affairs coordinator.

"We are thrilled that Rita Bowen, a highly accomplished leader in the HIM community who has served as a former president of AHIMA, will be joining our leadership committee as legislative and government affairs coordinator,” says Carlos Rodriguez, president of AHIOS. “With her deep industry and compliance expertise and ability to embrace change, Rita will be a valuable resource to the association, bolstering our advocacy and legislative initiatives that support increasing patient’s access to their medical records while maintaining patient privacy."

In her role as vice president of privacy, compliance, and HIM policy at MRO, Bowen ensures new and existing client HIM policies and procedures are to code. Bowen also serves as the company’s privacy and compliance officer, assuring timely reporting of any disclosure incident.

“I am delighted to be serving as the legislative and government affairs coordinator for AHIOS during this time when the industry is navigating the many challenges and critical issues associated with balancing patient access and privacy,” Bowen says. “I look forward to working with the AHIOS leadership team to address the ever-increasing and highly complex legislative and compliance issues and to strengthen the association’s advocacy and education initiatives that are essential to ensuring standards of excellence for the entire release of information industry.”

— Source: Association of Health Information Outsourcing Services