Currently, there is work being conducted that is tangential to the notion of patients amending notes which has been titled “OurNotes.”3 This intervention involves clinicians asking patients to write a brief history since their last visit and to identify three priorities for their upcoming visit in their online portal. Results from its pilot found that patients submitted these forms for fewer than ten percent of eligible visits. Ninety-two percent of patients thought the practice was a good idea, 69% believed that the questions helped them prepare for their visit, and all participating clinicians chose to continue utilizing OurNotes.

In contrast to OurNotes, or a patient messaging their care team to communicate a change in their goals or history, Amend Notes aims to be retrospective, going back to take out erroneous information that can lead to future care not being provided in alignment with the preferences and goals of the patient. While an addendum may be used to clarify information in a note or update erroneous information, we argue that physically removing the inaccurate information and replacing it avoids the potential for care team members to review the inaccurate note and miss the addendum or not fully appreciate it.

Amend Notes will be most effective for accuracy in the medication list, social history, and treatment plan sections of standard documentation. The facilitated sections for amendments could be customized based on the specialty and practice needs. In a study of the impact of reading visit notes on patients’ ability to manage medications, approximately eight out of ten survey respondents looked at their medication list at least once, with 18% reporting their list was inaccurate and 85% desiring the ability to submit corrections.4 While patients can request the removal of medications from their lists in many EHRs, this would not retrospectively correct the time the medical record indicated the patient was taking the medication.

Amendments in the treatment plan would aid in ensuring that the values and preferences of patients are being accurately communicated across members of their current and future care teams. For example, a patient may request access to components of their medical record and find that the description of their justification for making a medical decision was inaccurate. Through a patient-proposed amendment that was written in the patient’s own words, there would instead be a more direct, and therefore likely useful, statement of patient wishes in their medical record.

Finally, amendments in the psychosocial history would create additional space for patients to have their histories written in their own words, signaling through the medical record that patients are the experts on their own experience. Not only would patients be able to amend incorrect information, but they would also be able to add additional details about how they would like to be treated or addressed based on their background experiences and beliefs. Recent research has shown how the EHR is a place where unjust bias can manifest, with Black patients being 2.54 times more likely to have at least one negative descriptor in their history and physical notes when compared with White patients.5 Increasing space for patient voice through amendments in the psychosocial history would be one step forward in addressing such harms through creating new opportunities for patients to describe how their pasts and identities shape the care they want to receive.