TY - JOUR AU - Walker, Jan AU - Leveille, Suzanne AU - Kriegel, Gila AU - Lin, chen tan AU - Liu, Stephen K AU - Payne, Thomas H AU - Harcourt, Kendall AU - Dong, Zhiyong AU - Fitzgerald, Patricia AU - Germak, Matthew AU - Markson, Lawrence AU - Jackson, Sara L AU - Shucard, Hannah AU - Elmore, Joann G AU - Delbanco, Tom PY - 2021 DA - 201/11/8 TI -患者贡献访问笔记:JO - J Med Internet Res SP - e29951 VL - 23 IS - 11 KW -电子健康记录KW -访前信息KW -医患关系KW -患者门户KW -移动电话AB -背景:安全的患者门户广泛可用，患者使用它们来查看他们的电子健康记录，包括他们的临床记录。我们进行了实验，要求他们与他们的临床医生共同生成笔记，这种干预被称为“我们的笔记”。目的:本研究旨在评估试验性干预12个月后患者和提供者的经验和态度。方法:在预定的初级保健就诊之前，患者被要求提交一份文字限制的、非结构化的间隔史和一份他们想在就诊时讨论的议程。使用特定地点的方法，他们的提供者被邀请将提交的内容纳入记录访问的笔记。在波士顿(马萨诸塞州)、黎巴嫩(新罕布什尔州)、丹佛(科罗拉多州)和西雅图(华盛顿州)的4个学术健康中心的初级保健实践中，站点服务于城市、郊区和农村的患者。每家诊所都为患者提供了数年的电子访问记录(开放记录)。混合方法评价采用了跟踪数据和来自患者和临床医生的电子调查回复。参与者为174名提供者和1962名患者，他们至少提交了一份预访表。 We asked providers about the usefulness of the submissions, effects on workflow, and ideas for the future. We asked patients about difficulties and benefits of providing the requested information and ideas for future improvements. Results: Forms were submitted before 9.15% (5365/58,652) eligible visits, and 43.7% (76/174) providers and 26.76% (525/1962) patients responded to the postintervention evaluation surveys; 74 providers and 321 patients remembered receiving and completing the forms and answered the survey questions. Most clinicians thought interim patient histories (69/74, 93%) and patient agendas (72/74, 97%) as good ideas, 70% (52/74) usually or always incorporated them into visit notes, 54% (40/74) reported no change in visit length, and 35% (26/74) thought they saved time. Their most common suggestions related to improving notifications when patient forms were received, making it easier to find the form and insert it into the note, and educating patients about how best to prepare their submissions. Patient respondents were generally well educated, most found the history (259/321, 80.7%) and agenda (286/321, 89.1%) questions not difficult to answer; more than 92.2% (296/321) thought sending answers before the visit a good idea; 68.8% (221/321) thought the questions helped them prepare for the visit. Common suggestions by patients included learning to write better answers and wanting to know that their submissions were read by their clinicians. At the end of the pilot, all participating providers chose to continue the OurNotes previsit form, and sites considered expanding the intervention to more clinicians and adapting it for telemedicine visits. Conclusions: OurNotes interests patients, and providers experience it as a positive intervention. Participation by patients, care partners, clinicians, and electronic health record experts will facilitate further development. SN - 1438-8871 UR - //www.mybigtv.com/2021/11/e29951 UR - https://doi.org/10.2196/29951 UR - http://www.ncbi.nlm.nih.gov/pubmed/34747710 DO - 10.2196/29951 ID - info:doi/10.2196/29951 ER -