Transparency in health care can bring greater empowerment and enable more rational decision making for health consumers. Physicians acknowledge this: “We believe that increasing transparency in the health care system can be beneficial to both patients and physicians,” said J. Fred Raslton, Jr., MD, FACP, president of the American College of Physicians.

There’s an indication that patients will embrace transparency in the form of accessing their physicians’ notes about them, based on the OpenNotes project research published in the Annals of Internal Medicine this week.

The objective of the study was to measure the impact on doctors and patients of extending patients access to view their doctors’ notes over a secure Internet portal. The trial was done at three medical centers: Beth Israel Deaconess Medical Center in Massachusetts, Geisinger Health System in Pennsylvania, and Harborview Medical Center in Washington state. Some 13,564 patients and 105 primary care providers were involved in the study.

The finding that virtually all patients involved wanted to continue to have access to doctor’s notes is significant. However, even more powerful is that 62% of patients would like to be able to add comments to doctors’ notes, which one-third of doctors said would also be useful. One in 3 patients believe they should be entitled to “approve” the notes’ content; few physicians thought so.

A majority of patients agreed that OpenNotes could have many benefits for them, including taking better care of self, understanding health conditions, remembering care plans better, preparing for visits more effectively, feeling more in control of their care, and taking medications better. Fewer than one-half of physicians agreed that these potential benefits would accrue to patients.

Nonetheless, most physicians agreed that nothing was difficult about the OpenNotes program and they experienced no changes in their practice (such as workflow interruptions and productivity loss).

Health Populi’s Hot Points:   “We suspect that fear or uncertainty of what is in the doctor’s ‘black box’ may engender far more anxiety than what is actually written, and patients who are especially likely to react negatively to notes may self-select not to read them.”

For those patients who want to health-engage, the OpenNotes project gives credence to the fact that patients can handle the truth. (Cut here to Jack Nicholson and Tom Cruise in A Few Good Men). Beyond “reading” notes is the transformation that can happen within a patient on the journey toward empowerment: the researchers point to a quote from a patient focus group: “Having it written down, it’s almost like there’s another person telling you to take your meds.”

Thus begins the virtuous cycle of communication in the healthcare transparency ecosystem. Transparency brings enlightenment and empowerment in health care.

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17 Comments on "Patients want to see the notes their doctors write about them: the power of transparency in health care"

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Fannie Brown
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Fannie Brown
3 years 10 months ago
Given greater transparency in access to physician notes, does there exist the likelihood that physicians could unconsciously “self edit” knowing that the information can be accessed by a patient? I periodically ask for a copy of my medical record from each physician I see for a prolonged period of time even when I’m charged so I can get a complete picture beyond the hurried office visit. Physicians don’t always share everthing with you. Just recently I asked my PCP about one element in my blood work results that indicated a high “score” and she simply said, “it’s not important”. I… Read more »
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[…] read the article here! 33.673285 -95.516829 Share for your health!:FacebookEmailLinkedInTwitterRedditDiggStumbleUponPinterestLike this:LikeBe the first to like this. This entry was posted in Thought provokers…. and tagged doctor notes, Patient access by Tisha Clinkenbeard. Bookmark the permalink. […]

bruce kerr
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bruce kerr
3 years 10 months ago

.. It is a patient right. I always question and look at what is being written when i wanted to
I have even read over a doctors shoulder when he use an emr. I also would ask where in if i donte chart does it justify what you said when i don’t see it or understand.

Peter Mahaffey
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Peter Mahaffey
3 years 10 months ago
I note that the featured proponent of making sure that patients see their notes, Dr Raslton, says that this “CAN” be beneficial, not IS beneficial. There’s no proven evidence at all that the practice IS helpful. As a plastic surgeon, I for example want to be free to tell a family physician that parents who bring their small child insisting upon that his/her ears are pinned back when the child isn’t in the slightest bothered are excessively pushy and likely to damage the child. If thats my honest opinion then why shouldn’t i be able to express it in the… Read more »
Patrick Sweet, MD
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Patrick Sweet, MD
3 years 10 months ago

I agree with Dr. Mahaffey. I would contend also that patients do not always know what medical jargon means and this effort would only add work to the already overburdened physicians in having to offer frequent explanations or responses to comments when they may not even be pertinent. I like the way the VA handles this — up front explanation the patients do not have a right to access their medical records.

sandy halliburton
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sandy halliburton
3 years 10 months ago

i would like to be able to read all my mds’ notes…..but as a medical professional, at least i would understand them! i still remember being reported to my supervisor by a patient’s relative who heard me tell another rn that the pt. was SOB. she thought i had called him a son of a bitch!

Theresa Calluori
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Theresa Calluori
3 years 10 months ago

My doctor told me I was perfectly healthy. I am the poster child of all the correct numbers for whatever they assign numbers to. I was denied medical insurance because some one who sits at a desk at an insurance company read a meaningless note and decided I have a heart condition. I do not have a heart condition nor did I ever have a heart condition and now no one will insure me based on a lie. Even though the doctor appealled they still refuse me. I am infuriated!

BJ Lawson RN (ret)
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BJ Lawson RN (ret)
3 years 10 months ago
I don’t understand why people think this so-called transparency of their medical records is something new. I have known since the early ’70’s that “your” medical records are just that-yours. All that has ever been required to obtain a complete copy of your medical records from any doctor or hospital is to sign a “release of information” form available at the site of care. The info it asks for from you is mainly for clerical purposes-dates requested (ex. Jan 1- Dec 31 2011), how much info you want (just Dr notes or lab & x-ray also), & reason (so they… Read more »
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[…] engagement and participatory health in 2012. The positive results found earlier this week in the OpenNotes project (covered in Health Populi here) illustrates an emerging era of patient-doctor teamwork. This convergence is good news as the U.S. […]

Gabriel
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Gabriel
3 years 10 months ago

Transparency is great… When we’re dealing with informed, open minded and good willed people. Unfortunately, that is not always the case. If you look hard enough, you will find glitches in every medical record… Does that mean that patients are being ill treated? Medical records help doctors and other health professionals keep track of their work, they do not represent the work itself. In fact, where I work, the greater the work load, the thinner the records… Are patients being mistreated?

Caroline UGAVA
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Caroline UGAVA
3 years 10 months ago

Transparency between patient, family and medical pacticcitioners is the modern appproach that any practitioner should be promoting. In Papua New Guinea where there is no social suppot system…tansparency will transform families to providing lasting care and support to their loved-ones who are undergoing long and chronic illinesses. This wil also avoid the ever challenging medical and nursing care that is provided by the practicitioners in PNG.

Caroline UGAVA
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Caroline UGAVA
3 years 10 months ago

I support and promote trransparency

Monica Smith
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Monica Smith
3 years 10 months ago
I suspect that once the dust settles on early adoption trial-and-error, that consumers (and providers) will eventually and more fully embrace the accessible electronic health record (aehr). Keep in mind that the health care encounter, and documentation of same, encompasses the three main dimensions of biological, psychological, and social aspects (i.e. the BioPsychoSocial Model of healthcare). Therefore, I also would predict the following: that medical physicians will increasingly take responsibility (and accountability) for only the “biological” component of the health record; while the responsibility/accountability for the “psycho-social” components of the health record will increasingly be pushed onto nurses or other… Read more »
Transparent Pricing
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3 years 1 month ago

Transparency is key to our industry’s future. I think its hard to argue against that. The professionals are on-board, the patients are in need, and the technology is now there. Yes! What more could we all ask for.

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[…] and providers. The relationship between patient and doctor still holds trust. Growing acceptance of Open Notes and other transparency projects that focus on shared decision making between people and their […]

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[…] this context, we discussed the Open Notes project sponsored by the Robert Wood Johnson Foundation, which found that once physicians opened their […]

Deborah
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Deborah
1 year 5 months ago
I took an alcohol assessment and want to see their results. They will not show them to me. Isn’t that against the privacy act? I ask, “Well, what do you have to hide from me?” The courts had me do this and the worse thing is that I have a year sober now with a good track record of sobriety and now I have to do an “Intensive Out-Treatment Program”? It’s a waste of taxpayer’s money, my time and gas money for me to have to go through it when I’m not having an issue with sobriety at all. What… Read more »
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