Open Notes in Brain Injury Rehabilitation Part 2: Provider and Patient Preferences for Artificial Intelligence Solutions.

OBJECTIVE

To characterize opinions and experiences related to the use of artificial intelligence (AI) in the context of patient-accessible electronic medical records in rehabilitation (or "open notes").

DESIGN

Rehabilitation providers and patients with acquired brain injury (ABI) completed a web-based survey.

SETTING

Provider participants were recruited via publicly available email lists published by licensure boards and via internal listservs within a large Midwestern health care system. Patient participants were recruited via medical records search within the same health care system.

PARTICIPANTS

A total of 677 providers and 270 patients with ABI completed the survey. Providers (physical therapy, occupational therapy, and speech-language pathology) were working in settings that use electronic health records. Adults with ABI had received rehabilitative care between 2021 and 2024.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Participants responded to multiple-choice, Likert-scale, and open-response questions regarding their experiences with and opinions about AI in the context of clinical documentation in rehabilitation.

RESULTS

Both groups reported little experience with AI in daily life or health care contexts. Both groups reported concerns regarding AI accuracy and privacy. Most providers expressed interest in AI tools for supporting clinical documentation; patients with ABI expressed more hesitancy. Both groups agreed that a patient-directed summary would be helpful for improving the utility of open notes. Both groups rated goals, progress, activities, and home exercise programs as the most important note components for patients to understand.

CONCLUSIONS

Rehabilitation providers and patients with ABI agree that patient-directed note summaries may be one way to improve open notes. Generative AI provides 1 potential pathway for creating such a summary without undue clinician burden, but both providers and patients express significant concerns about accuracy and privacy. Future work should continue to evaluate the potential of AI solutions for improving patient-provider communication in the open notes era while mitigating potential drawbacks.