Boston’s Beth Israel-Deaconess Hospital is engaging in a year-long project called OpenNotes, which will look at what happens when patients are given real-time unrestricted access to their medical chart. HIPAA gives patients the legal right to access their medical records, but actually getting them is often a slow, laborious process. This project will give patients access to their electronic record immediately following an office visit.
Is this a good idea?
Having easy access to their physicians’ notes could help patients remember what was discussed during the appointment. But many physicians are wary. Some physicians anticipate that patients will be worried and confused by medical jargon they don’t comprehend, and that doctors will have to spend time translating their notes into patient-friendly laymen’s terms. Some attorneys are concerned that having their doctor’s notes could give dissatisfied patients fuel for malpractice claims.
However, making access to the medical notes easier can offer opportunities for patients to better collaborate with their doctors. For instance, patients who are actively involved can question the necessity of a specific test. And medical errors may be reduced when the doctor’s notes are reviewed by an expert on the patient – the patient himself.
Ready access to the medical chart will only make it easier for patients to take control of their own health.
I encourage you to listen and vote in this week’s poll, located both below, and in the upper right column of the blog.
Please suggest future ReachMD Poll topics by emailing Poll@ReachMD.com.
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- Reader take: Patients should be allowed to access their entire medical record
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{ 7 comments }
there are checkboxes on my ED charts like “obese” and “poor hygiene” that would probably go checked much less often if patients were allowed to read the chart. heh.
I always give patients a hard copy of their test results but only when they are in the office with me so I can explain the medical language. When was the last time you read a radiology report that did not suggest another study or had words like “probably” or “if clinically indicated”. How will a patient understand that without a physician explaining that in the context of their clinical evaluation.? Of course a patient should have that information but how does the doc get reimbursed for the time he will have to spend reassuring the patient that the medical jargon in their chart or report is “normal back ground noise”. Most likely the patient will need to or want to make a followup office visit to discuss the information. It will be interesting to see how this plays out but in my experience the more information the better AS LONG AS the patient gets the interpretation of what is in their chart from their doctor and not their next door neighbor.
My experience shows that it would be good for the patient. For example, my wife had a pacemaker implanted. One of the leads perforated her heart and was pacing her chest wall. This interfered with her anti-arrhythmics. She wound up having a disastrous catheter ablation for Afib. The various docs wrote notes to each other that it was the pacemaker having the pro-arrhythmic effect, not the Rythmol, Sotalol, Flecanide, etc.
Nevertheless, she was told that these anti-arrythmics had failed and that therefore a PVI ablation was in order.
Had we seen the Doc’s notes, the tragedy would have been avoided:
There seems to be a lot of concern among physicians that many patients will become confused or frightened because they won’t understand the notes in their medical records. I can’t help wondering how many patients who don’t understand the notes will bother to read them.
I can understand the difficult position doctors are in. It seems to me that most people lack the inclination or are intimidated by the lingo — or are just lazy or distracted enough to leave it all in the Doc’s lap.
I know a lot of people who return from a doctor visit with little grasp of what went on or what the prognosis or plans might be.
As a patient who has done some research on this topic, certainly no scientific study, I have found that some doctors encourage patients to check their report.
Doctors who have checked their own have been surprised at the medical errors that they have found. Mine have all been accurate and I appreciate seeing that my doctors find me to be cheerful. I have to admit when I first looked at mine, I was a bit insulted when I saw the word unremarkable, then I realized that unremarkable was good.
When I talk to most of my friends, I seem to be the only one to bother getting my reports, so I can’t imagine there would be a great need for this service.
When I went to see another doc for pertusis, she never gave me my results unless I came in for another appt. Who has time for that? My insurance company reimburses for e-mail answers, so she could have informed me in that manner. I went doctor shopping for someone willing to give me insignificant results sooner, without having to wait for an office visit. Having this service would be a great benefit to me.
I agree, when possible, it’s nice to share the reports with your patients in person. That’s why I get my CT and blood work and four hours later I meet with my doc to go over the findings. If I have more questions later, he e-mails me back within the week.
As an informed patient, I appreciate seeing that all of my information is accurate (not to mention that I tape record all of my appointments). Plus, when my insurance company intially denied all of my treatments, my medical reports and recordings helped me formulate my letters to them to ensure that they paid 100% of what they should have.
Although it may be difficult to tell a patient they have issues, it is to their benefit. Some people have no idea they smell, and their friends and family are too polite to inform them. After my hygenist nagged me for years to floss, I finally floss. We worked together to find a system that worked for me, that would remind me to floss. Had she not been so diligent, I’d still not floss today.
I ask (and receive) a hard copy of all test results and then enter on Google Health. I’ve never had the need to retrieve them, but it’s reassuring to have the history there.
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