Evaluation of a patient-centered after visit summary in primary care

• Published in: Patient education and counseling 2018-08, Vol.101 (8), p.1483-1489
• Main Authors: Federman, Alex D., Jandorf, Lina, DeLuca, Joseph, Gover, Mary, Sanchez Munoz, Angela, Chen, Li, Wolf, Michael S., Kannry, Joseph
• Format: Article
• Language: English
• Subjects: After visit summary; Electronic health record (EHR); Electronic Health Records; Female; Health literacy; Humans; Interviews as Topic; Male; Medication Adherence; Middle Aged; New York City; Nursing; Patient-Centered; Patient-Centered Care; Primary Health Care; Self Care
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2018.02.017

•Introduction of a patient-centered AVS increased the number of patients receiving the document.•Patients report that the modified AVS serves as a helpful reminder to take their medications.•Clinicians who rated the AVS positively are more likely to provide the document to their patients. To test the impact of a redesigned, patient-centered after visit summary (AVS) on patients’ and clinicians’ ratings of and experience with the document. We conducted a difference-in-differences (DiD) evaluation of the impact of the redesigned AVS before and after its introduction in an academic primary care practice compared to a concurrent control practice. Outcomes included ratings of the features of the AVS. The intervention site had 118 and 98 patients in the pre- and post-intervention periods and the control site had 99 and 105, respectively. In adjusted DiD analysis, introduction of the patient-centered AVS in the intervention site increased patient reports that the AVS was an effective reminder for taking medications (p = .004) and of receipt of the AVS from clinicians (p = .002). However, they were more likely to perceive it as too long (p = .04). There were no significant changes in overall rating of the AVS by clinicians or their likelihood of providing it to patients. A patient-centered AVS increased the number of patients receiving it and reporting that it would help them remember to take their medications. Improvements in the patient-centeredness of the AVS may improve its usefulness as a document to support self-management in primary care.