Joanna Veazey Brooks PhD, MBE , Delisia Chapman-Brown MPH , Amanda Thimmesch BA , Elizabeth Wulff-Burchfield MD , Christian Sinclair MD , Daniel English MSGH , Heather Nelson-Brantley PhD, RN, NEA-BC, CNE
{"title":"临床医生对肿瘤姑息治疗开放笔记的看法:一项混合方法研究。","authors":"Joanna Veazey Brooks PhD, MBE , Delisia Chapman-Brown MPH , Amanda Thimmesch BA , Elizabeth Wulff-Burchfield MD , Christian Sinclair MD , Daniel English MSGH , Heather Nelson-Brantley PhD, RN, NEA-BC, CNE","doi":"10.1016/j.jpainsymman.2025.07.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Context</h3><div>The 21st Century Cures Act Interoperability and Information Blocking Rule (IBR) has the laudable goal of increased transparency in sharing health information with patients and informed decision-making by patients, yet strategies to support IBR implementation are sparse. Without evidence-based guidelines, health systems and palliative care clinicians have been left to navigate implementation of the IBR on their own.</div></div><div><h3>Objectives</h3><div>We sought to understand clinician perspectives and experiences with the IBR in oncology and palliative care.</div></div><div><h3>Methods</h3><div>We used a convergent parallel mixed method design with clinician surveys and interviews.</div></div><div><h3>Results</h3><div>29 clinicians from one institution participated in the study. Three themes emerged from the data: 1) specialty-specific worry about harm; 2) documentation changes in response to the IBR; and 3) sharing notes as a helpful tool. We found that clinicians see benefits and concerns around the IBR. Oncology clinicians worried more about the sensitivity of test results while palliative care clinicians worried more about the sensitivity of information included in documentation of family meetings and of prognostic information.</div></div><div><h3>Conclusion</h3><div>Findings from our study indicate that clinicians’ experience with the IBR is more nuanced than the initial worry expressed by clinicians in editorials. Additionally, our study shows the importance of capturing specialty-specific experiences with the IBR, as concerns can differ. Future research should continue to examine clinician and organizational practices around implementation of the IBR to identify best practices for maximizing patient and clinician benefit while minimizing unintended harm.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"70 5","pages":"Pages 410-421"},"PeriodicalIF":3.5000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinician Perspectives on Open Notes in Oncology Palliative Care: A Mixed-Methods Study\",\"authors\":\"Joanna Veazey Brooks PhD, MBE , Delisia Chapman-Brown MPH , Amanda Thimmesch BA , Elizabeth Wulff-Burchfield MD , Christian Sinclair MD , Daniel English MSGH , Heather Nelson-Brantley PhD, RN, NEA-BC, CNE\",\"doi\":\"10.1016/j.jpainsymman.2025.07.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Context</h3><div>The 21st Century Cures Act Interoperability and Information Blocking Rule (IBR) has the laudable goal of increased transparency in sharing health information with patients and informed decision-making by patients, yet strategies to support IBR implementation are sparse. Without evidence-based guidelines, health systems and palliative care clinicians have been left to navigate implementation of the IBR on their own.</div></div><div><h3>Objectives</h3><div>We sought to understand clinician perspectives and experiences with the IBR in oncology and palliative care.</div></div><div><h3>Methods</h3><div>We used a convergent parallel mixed method design with clinician surveys and interviews.</div></div><div><h3>Results</h3><div>29 clinicians from one institution participated in the study. Three themes emerged from the data: 1) specialty-specific worry about harm; 2) documentation changes in response to the IBR; and 3) sharing notes as a helpful tool. We found that clinicians see benefits and concerns around the IBR. Oncology clinicians worried more about the sensitivity of test results while palliative care clinicians worried more about the sensitivity of information included in documentation of family meetings and of prognostic information.</div></div><div><h3>Conclusion</h3><div>Findings from our study indicate that clinicians’ experience with the IBR is more nuanced than the initial worry expressed by clinicians in editorials. Additionally, our study shows the importance of capturing specialty-specific experiences with the IBR, as concerns can differ. Future research should continue to examine clinician and organizational practices around implementation of the IBR to identify best practices for maximizing patient and clinician benefit while minimizing unintended harm.</div></div>\",\"PeriodicalId\":16634,\"journal\":{\"name\":\"Journal of pain and symptom management\",\"volume\":\"70 5\",\"pages\":\"Pages 410-421\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of pain and symptom management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0885392425007341\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0885392425007341","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Clinician Perspectives on Open Notes in Oncology Palliative Care: A Mixed-Methods Study
Context
The 21st Century Cures Act Interoperability and Information Blocking Rule (IBR) has the laudable goal of increased transparency in sharing health information with patients and informed decision-making by patients, yet strategies to support IBR implementation are sparse. Without evidence-based guidelines, health systems and palliative care clinicians have been left to navigate implementation of the IBR on their own.
Objectives
We sought to understand clinician perspectives and experiences with the IBR in oncology and palliative care.
Methods
We used a convergent parallel mixed method design with clinician surveys and interviews.
Results
29 clinicians from one institution participated in the study. Three themes emerged from the data: 1) specialty-specific worry about harm; 2) documentation changes in response to the IBR; and 3) sharing notes as a helpful tool. We found that clinicians see benefits and concerns around the IBR. Oncology clinicians worried more about the sensitivity of test results while palliative care clinicians worried more about the sensitivity of information included in documentation of family meetings and of prognostic information.
Conclusion
Findings from our study indicate that clinicians’ experience with the IBR is more nuanced than the initial worry expressed by clinicians in editorials. Additionally, our study shows the importance of capturing specialty-specific experiences with the IBR, as concerns can differ. Future research should continue to examine clinician and organizational practices around implementation of the IBR to identify best practices for maximizing patient and clinician benefit while minimizing unintended harm.
期刊介绍:
The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.