The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index; none of the 40 sources its claims cite is checked for support yet.
A patient and family reporting system for perceived ambulatory note mistakes: experience at 3 U.S. healthcare centers
Open accessAbstract
Objective: The study sought to test a patient and family online reporting system for perceived ambulatory visit note inaccuracies. Materials and Methods: We implemented a patient and family electronic reporting system at 3 U.S. healthcare centers: a northeast urban academic adult medical center (AD), a northeast urban academic pediatric medical center (PED), and a southeast nonprofit hospital network (NET). Patients and families reported potential documentation inaccuracies after reading primary care and subspecialty visit notes. Results were characterized using descriptive statistics and coded for clinical relevance. Results: We received 1440 patient and family reports (780 AD, 402 PED, and 258 NET), and 27% of the reports identified a potential inaccuracy (25% AD, 35% PED, 28% NET). Among these, patients and families indicated that the potential inaccuracy was important or very important in 58% of reports (55% AD, 55% PED, 71% NET). The most common types of potential inaccuracies included description of symptoms (21%), past medical problems (21%), medications (18%), and important information that was missing (15%). Most patient- and family-reported inaccuracies resulted in a change to care or to the medical record (55% AD, 67% PED, data not available at NET). Discussion: About one-quarter of patients and families using an online reporting system identified potential documentation inaccuracies in visit notes and more than half were considered important by patients and clinicians, underscoring the potential role of patients and families as ambulatory safety partners. Conclusions: Partnering with patients and families to obtain reports on inaccuracies in visit notes may contribute to safer care. Mechanisms to encourage greater use of patient and family reporting systems are needed.
Overview
CoChat Summary
TL;DR
A patient and family online reporting system for perceived ambulatory visit note mistakes was implemented at 3 U.S. healthcare centers, yielding 1440 reports. About 27% identified a potential documentation inaccuracy, and many led to changes in care or the medical record.
Key findings
- Of 1440 patient and family reports (780 AD, 402 PED, 258 NET), 27% identified a potential inaccuracy (25% AD, 35% PED, 28% NET).
- Among those identifying a possible inaccuracy, 58% rated it important or very important (55% AD, 55% PED, 71% NET).
- Most common perceived inaccuracies were symptoms (21%), past medical problems (21%), medications (18%), and important missing information (15%).
- Among reviewed cases at AD and PED, 55% AD and 67% PED resulted in a change to care or the medical record; NET outcome data were not available.
Methods
- Implemented a patient and family electronic reporting system at 3 U.S. healthcare centers: a northeast urban academic adult medical center (AD), a northeast urban academic pediatric medical center (PED), and a southeast nonprofit hospital network (NET).
- Patients and families reported potential documentation inaccuracies after reading primary care and subspecialty visit notes; reports were characterized using descriptive statistics and coded for clinical relevance.
- At AD and PED, reports flowed through a QI review algorithm with patient relations follow-up and coding of safety concerns; NET used modified implementation and HIM follow-up when requested.
Limitations
- The paper states the voluntary reporting tool likely captures only a small fraction of all note inaccuracies, with low overall response rate and possible self-selection bias among portal-registered patients and families.
- The paper states note-reading rates could not be tracked at each site, and portal use disparities by health literacy, education, race, and primary language may bias findings.
- The paper states NET outcomes were not systematically coded, some questions differed slightly across sites, and the QI experience is not intended to be generalizable to other organizations or geographic areas.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
0 Valid · 0 Not valid · 21 Not checked · 76 Own results and interpretations
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Across the 3 sites, an average of 90% of participants reported that they understood their notes.”
plainn = 1,400- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Relatively few reports indicated bothersome language in the note (9% AD, 8% PED; not available for NET).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“more than half were considered important by patients and clinicians”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among these, patients and families rated 58% of the possible inaccuracies they identified as important or very important.”
plainn = 1,400- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At AD and PED, the majority of cases deemed by patient relations to require further evaluation resulted in an amendment to the medical record or a change in practice, and the majority were considered actual or possible safety concerns on QI review.”
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
45 more claims
Create a free account to see all 97 claims and to verify the 40 references still open.
- It may state two separate claims as one. 30
- Probably not a substantial claim. 24
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“A few of these suggestions are in active testing with positive early findings.15,23,32,33”
From Speaking up about patient-perceived serious visit note errors: Patient and family experiences and recommendations (2021) · cites this paper as [23]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Healthcare providers declined to make changes in 4 of 137 (4%) of cases at AD”
Reported 4 · recomputed 2.919708
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“At NET, 70 of 237 (29%) indicated that reading their note had affected the way they think about their provider”
Reported 29 · recomputed 29.535865
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Number of completed reports 780 402 258 Understood the note 734 (94) 363 (90) 215 (87) a Understood the care plan 739 (95) 377 (94) 225 (92) b Expected to follow the care plan 313 (98) c , d 367 (97) N/A Potential documentation inaccuracy 193 (25) 139 (35) 66 (28) f Yes 175 (22) 123 (30) 55(23)”
Reported 30 · recomputed 30.597015
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Overall, 398 (27%) patient and family reports at all 3 sites”
Reported 27 · recomputed 27.638889
Citations
Cites
Adverse Drug Events in Ambulatory Care
Gandhi, T. K., Weingart, S. N., Borus, J., Seger, A. C., Peterson, J., Burdick, E., Seger, D. L., Shu, K., Federico, F., Leape, L. L., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmsa020703 · Cited by 1,345
Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study and a Look Ahead
Delbanco, T., Walker, J., Bell, S. K., Darer, J. D., Elmore, J. G., Farag, N., Feldman, H. J., Mejilla, R., Ngo, L., Ralston, J. D., et al. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-7-201210020-00002 · Cited by 685
Self-citationSingh, H., Meyer, A. N. D., & Thomas, E. J. (2014) · BMJ Quality & Safety · doi:10.1136/bmjqs-2013-002627 · Cited by 677
Types and Origins of Diagnostic Errors in Primary Care Settings
Singh, H., Giardina, T. D., Meyer, A. N. D., Forjuoh, S. N., Reis, M. D., & Thomas, E. J. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.2777 · Cited by 559
Sarkar, U., Karter, A. J., Liu, J. Y., Adler, N. E., Nguyen, R., López, A., & Schillinger, D. (2010) · Journal of Health Communication · doi:10.1080/10810730.2010.499988 · Cited by 366
Detecting adverse events for patient safety research: a review of current methodologies
Murff, H. J., Patel, V. L., Hripcsak, G., & Bates, D. W. (2003) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2003.08.003 · Cited by 357
Weissman, J. S., Schneider, E. C., Weingart, S. N., Epstein, A. M., David-Kasdan, J., Feibelmann, S., Annas, C. L., Ridley, N., Kirle, L., & Gatsonis, C. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-149-2-200807150-00006 · Cited by 324
Woods, S. S., Schwartz, E., Tuepker, A., Press, N. A., Nazi, K. M., Turvey, C. L., & Nichol, W. P. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2356 · Cited by 268
Kim, M. O., Coiera, E., & Magrabi, F. (2017) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocw154 · Cited by 263
Can Electronic Clinical Documentation Help Prevent Diagnostic Errors?
Schiff, G. D., & Bates, D. W. (2010) · New England Journal of Medicine · doi:10.1056/nejmp0911734 · Cited by 238
Research works printed but not linked: 5
- National Patient Safety Foundation, 2014, SAFETY IS PERSONAL Partnering with Patients and Families for the Safest Care: The National Patient Safety Foundation’s Lucian Leape Institute Report of the Roundtable on Consumer Engagement in Patient Safety
- National Patient Safety Foundation, Lucian Leape Institute, 2015, Shining a Light: Safer Health Care Through Transparency
- Bourgeois, 2018, Harvard Medical School Course BMI 720: Clinical Informatics
- Bell, 2018, Tackling Ambulatory Safety Risks Through Patient Engagement, J Patient Saf., 1
- Bell, 2016, When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient–doctor relationship, BMJ Qual Saf., 0, 1
Cited by
Biases in Electronic Health Records Data for Generating Real-World Evidence: An Overview
Al‐Sahab, B., Leviton, A., Loddenkemper, T., Paneth, N., & Zhang, B. (2023) · Journal of Healthcare Informatics Research · doi:10.1007/s41666-023-00153-2 · Cited by 81
Hagström, J., Blease, C., Haage, B., Scandurra, I., Hansson, S., & Hägglund, M. (2022) · Journal of Medical Internet Research · doi:10.2196/40328 · Cited by 51
Patients Contributing to Visit Notes: Mixed Methods Evaluation of OurNotes
Walker, J., Leveille, S. G., Kriegel, G., Lin, C., Liu, S. K., Payne, T. H., Harcourt, K., Dong, Z., Fitzgerald, P., Germak, M., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/29951 · Cited by 38
Lam, B. D., Bourgeois, F., Dong, Z. J., & Bell, S. K. (2021) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa293 · Cited by 29
Self-citationEVIDENCE-BASED MEDICINE AS PATIENT'S PROTECTION MEASURE IN JUDICIAL PRACTICE
Zhuravel, V. A., Avdeeva, G. K., & Sokolenko, M. O. (2020) · Wiadomości Lekarskie · doi:10.36740/wlek202012216 · Cited by 27
Metadata
- Authors
- Bourgeois, F. C., Fossa, A., Gerard, M., Davis, M. E., Taylor, Y. J., Connor, C. D., Vaden, T., McWilliams, A., Spencer, M. D., Folcarelli, P., & Bell, S. K.
- Affiliations
- Boston Children's Hospital (US)
- Beth Israel Deaconess Medical Center (US)
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, North Carolina, USA
- Department of Internal Medicine, Atrium Health, Charlotte, North Carolina, USA
- Corresponding author
- Bourgeois, Fabienne C
- ORCID
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-09-03
- Volume
- 26
- Issue
- 12
- Pages
- 1566-1573
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC7647145
- OpenAlex
- W2972223492
- Semantic Scholar
- 7b618f4e0e50b164dc191597b229d6f17e7e59da
- Cited by
- 25
- References
- 40
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 1
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion)
- Funders
- CRICO/Risk Management Foundation
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Keywords
- online reporting system, patient safety, outpatient care, primary care, pediatric care, patient engagement, medication errors
- MeSH terms
- Adult, Ambulatory Care, Ambulatory Care Facilities, Child, Communication, Documentation, Family, Feedback, Humans, Online Systems, Patient Participation, United States, Electronic Health Records
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- The paper
- Bourgeois, F. C., Fossa, A., Gerard, M., Davis, M. E., Taylor, Y. J., Connor, C. D., Vaden, T., McWilliams, A., Spencer, M. D., Folcarelli, P., & Bell, S. K. (2019). A patient and family reporting system for perceived ambulatory note mistakes: experience at 3 U.S. healthcare centers. Journal of the American Medical Informatics Association. https://doi.org/10.1093/jamia/ocz142
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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