Journal of Medical Internet Research· 2026Q1
Patient Use of a Comment Function in Electronic Health Records: Mixed Methods Case Study
- 0citations
- Q1SCImago
- 2026year
Short summary
Of 1670 patient comments on EHRs, 57.3% related to non-note content and 42.4% were negative, with mental health patients leaving more comments and more negative ones (63.2% vs 33.5%).
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Key points
- 1670 patient comments were analyzed from the Swedish national EHR between 2015-2021.
- 57.3% of comments addressed issues beyond direct note content.
- 42.4% of comments carried a negative sentiment.
- Patients referencing mental health care left more comments (median 7 vs 2) and had a higher rate of negative comments (63.2% vs 33.5%).
- Key comment categories included care engagement, perceived inaccuracies, complaints, and requests.
AI-generated from the title and abstract; the full text is not read.
Abstract
BACKGROUND Patient access to their electronic health records (EHRs) could improve care and reduce errors by enabling patient contribution to documentation. However, interactive functions that support such engagement remain underresearched. OBJECTIVE The purpose of this study was to analyze patients’ use of the free-text comment function in the Swedish national patient-accessible EHR. METHODS Comments made by patients between 2015 and 2021 for health care professionals to view were retrieved from the patient-accessible EHR administration service in Sweden. The number and length of comments were analyzed using descriptive statistics and chi-square tests, while the content was examined qualitatively using inductive content analysis. In addition, comments were coded for sentiment (positive, neutral, or negative) and note content, and users were classified according to whether they had submitted at least 1 comment referring to mental health care. RESULTS A total of 1670 comments were left by 659 patients, of which 15 had irrelevant content (15/1670, 0.9%; 95% CI 0.4%-1.4%), leaving 1655 comments for analysis. Most comments (948/1655, 57.3%; 95% CI 54.9%-59.7%) were related to matters other than note content, and nearly all had a neutral (920/1655, 55.6%; 95% CI 53.2%-58.0%) or negative (702/1655, 42.4%; 95% CI 40.0%-44.8%) sentiment. Patients who submitted a comment referencing mental health care tended to leave more comments overall (median 7 vs 2 comments per patient), and their comments were more frequently negative than comments written by other patients (313/495, 63.2% vs 389/1160, 33.5%; P<.001). The most prevalent categories were care engagement, perceived inaccuracies, complaints, and requests. CONCLUSIONS Patient engagement with clinical notes has the potential to enhance documentation accuracy and strengthen patient-clinician communication. To realize these benefits safely, such features must be deliberately designed and clearly explained to users to avoid patient safety risks and unnecessary burdens on health care professionals.
The authors' abstract, as published at the source. Journal of Medical Internet Research, 2026 · DOI ↗
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Field: Health Information Management
Health Information ManagementHealth Professions