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The following is a summary of “Determining implementation issues of open notes in primary care: a focus group study,” published in the April 2025 issue of BMC Primary Care by Dees et al. 

Patients in many countries can access medical records online, but usage remains low. Healthcare professionals’ views and a clear implementation framework are lacking. 

Researchers conducted a retrospective study using the capability approach to assess open notes in general practice, highlighting key factors, opportunities, and challenges for patients and staff. 

They conducted qualitative research in 10 Dutch general practices with 19 professionals and 29 patients, selected through purposive sampling. They held 3 staff and 10 patient focus groups, analyzed transcripts using content analysis in ATLAS.ti, coded independently in 3 rounds by 2 researchers, and discussed results with the team to identify influencing factors. 

The results showed that personal, social, and environmental factors like digital and health literacy, social support, and legislation influenced open notes use. Patients and professionals largely agreed on these. The results showed 4 implementation themes: ownership ambiguity and data integrity concerns, need for support in practice changes, fear of unknown outcomes, and shifts in professional-patient dynamics requiring new skills. 

Investigators provided insight into how patients and healthcare professionals experienced open notes. They identified practical barriers, facilitators, and 4 themes to guide future implementation for better engagement and outcomes. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02805-1