Patients commonly suffer adverse events while in hospital. The fact that patients are often neither allowed to read documented warning signs in their own medical records nor able to record their wellbeing, symptoms and concerns in a way that is notable for health care professionals is a contributing factor. There is a significant body of literature on patient held medical records, but this relates near exclusively to patients in primary care and chronic disease management programs and knowledge about safety impact of patient held records is largely limited to medication safety. It is not known how patients in hospital could contribute to paper or electronic records and what effects this might have.

Scoping reviews of the literature showed little evidence for safety impact of electronic health records, personal health records or patient held mHealth applications.
Focus groups and workshops with patients established understanding of the opportunities and barriers to patient participation in emergency care and resulted in a novel model for rapid co-design of prototype interventions.

Interventional studies showed feasibility and utility of an mHealth check-list for side-effects of treatments of cancer. Patients who documented their priorities for a hospital admission added insights into their ideas, concerns and expectations that were not covered elsewhere in clinical records.

Insights from the work discussed in this submission suggest that patient contribution might facilitate change in safety outcomes by creating capability and opportunity for desirable changes in behaviour of individuals and systems and encourage and support patients to be involved in their own safety.

Further development and testing of systems that enable broader participation of patients is needed and is likely to empower patients while making health care professionals more aware of risks, change their behaviour and lead to safer delivery of health care in hospitals.