Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in SwedenShow others and affiliations
2023 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, article id e47841Article in journal (Refereed) Published
Abstract [en]
BACKGROUND: Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC. OBJECTIVE: The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups. METHODS: Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square. RESULTS: Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were "very important," but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups. CONCLUSIONS: About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records.
Place, publisher, year, edition, pages
JMIR Publications, 2023. Vol. 25, article id e47841
Keywords [en]
EHR, electronic health records, mental health, mental health care, national survey, online records access, open notes, ORA, PAEHR, patient-accessible electronic health record, patients, user experiences, adolescent, article, documentation, education, electronic health record, employment, encouragement, female, gender, health status, health survey, human, major clinical study, male, prevalence, Sweden
National Category
Computer Sciences Information Systems Information Systems, Social aspects Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Information Systems
Identifiers
URN: urn:nbn:se:his:diva-23364DOI: 10.2196/47841ISI: 001104378500001PubMedID: 37921861Scopus ID: 2-s2.0-85176200077OAI: oai:DiVA.org:his-23364DiVA, id: diva2:1812417
Funder
NordForsk, 100477Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-01229
Note
CC BY 4.0 DEED
©Annika Bärkås, Anna Kharko, Charlotte Blease, Åsa Cajander, Asbjørn Johansen Fagerlund, Isto Huvila, Monika Alise Johansen, Bridget Kane, Sari Kujala, Jonas Moll, Hanife Rexhepi, Isabella Scandurra, Bo Wang, Maria Hägglund. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 03.11.2023.
Corresponding Author: Annika Bärkås, MScParticipatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, 1tr, Uppsala, 752 37, Sweden. Phone: 46 734697471. Email: annika.barkas@kbh.uu.se
This work was supported by NordForsk through the funding to Nordic eHealth for Patients: Benchmarking and Developing forthe Future, NORDeHEALTH (Project #100477), and the Swedish Research Council for Health, Working Life, and Welfare (FORTE) through the funding to Beyond Implementation of eHealth (Project #2020-01229). CB was supported by a Keane Scholar Award. The study funders played no role in the study design, data interpretation, writing of the results, or decision to submit the manuscript for publication.
2023-11-162023-11-162024-04-15Bibliographically approved