Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in Sweden

BackgroundPrevious 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 p...

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Main Authors: Annika Bärkås (Author), Anna Kharko (Author), Charlotte Blease (Author), Åsa Cajander (Author), Asbjørn Johansen Fagerlund (Author), Isto Huvila (Author), Monika Alise Johansen (Author), Bridget Kane (Author), Sari Kujala (Author), Jonas Moll (Author), Hanife Rexhepi (Author), Isabella Scandurra (Author), Bo Wang (Author), Maria Hägglund (Author)
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Published: JMIR Publications, 2023-11-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Annika Bärkås  |e author 
700 1 0 |a Anna Kharko  |e author 
700 1 0 |a Charlotte Blease  |e author 
700 1 0 |a Åsa Cajander  |e author 
700 1 0 |a Asbjørn Johansen Fagerlund  |e author 
700 1 0 |a Isto Huvila  |e author 
700 1 0 |a Monika Alise Johansen  |e author 
700 1 0 |a Bridget Kane  |e author 
700 1 0 |a Sari Kujala  |e author 
700 1 0 |a Jonas Moll  |e author 
700 1 0 |a Hanife Rexhepi  |e author 
700 1 0 |a Isabella Scandurra  |e author 
700 1 0 |a Bo Wang  |e author 
700 1 0 |a Maria Hägglund  |e author 
245 0 0 |a Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in Sweden 
260 |b JMIR Publications,   |c 2023-11-01T00:00:00Z. 
500 |a 1438-8871 
500 |a 10.2196/47841 
520 |a BackgroundPrevious 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. ObjectiveThe 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. MethodsOur 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. ResultsOf 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. ConclusionsAbout 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. 
546 |a EN 
690 |a Computer applications to medicine. Medical informatics 
690 |a R858-859.7 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Journal of Medical Internet Research, Vol 25, p e47841 (2023) 
787 0 |n https://www.jmir.org/2023/1/e47841 
787 0 |n https://doaj.org/toc/1438-8871 
856 4 1 |u https://doaj.org/article/8288c569d20d462dacad3e042f41f816  |z Connect to this object online.