Are you interested in reading the medical notes your doctor writes about you? Some ten thousand patients around the country recently had that chance. And both they, and their doctors, said it led to better care.
More than 100 doctors in Boston, Seattle, and Danville, Pa., participated in the study, called OpenNotes, which was published today in the Annals of Internal Medicine. Patients could view their doctor's notes through a secure online website after being notified by e-mail.
Before it started, the physicians expressed concerns about their workflow as well as patient confusion, questions, and privacy. Patients, on the other hand, overwhelmingly welcomed the idea. After a year, 99 percent of patients remained enthusiastic, though a few acknowledged some confusion, offense, or worry by what they read. And the doctors, in general, didn't report the problems they had anticipated, with many feeling patient relationships were improved. In fact, when given the chance to drop out of the program, not a single doctor did so.
Two notable findings: Most patients on medications said they were more likely to take their prescriptions as directed. And many patients said they were better prepared and understood their condition better. Both are things our surveys of doctors and patients have identified as important to high quality health care.
Bottom line: The study provides additional proof that patients do better when doctors share more information, not less, and make information available where and when a patient wants it, not when it is convenient for the doctor. Some physicians may worry that more information will mean more questions, more time, and more confusion. But the opposite is usually the case. And some physicians think more information increases their risk of being sued for malpractice. But more information, when it's well organized and honestly shared, promotes trust and understanding. And in many cases, it isn't the mistake that causes trouble, it's the cover up.
When I practiced in Oregon at the Portland VA hospital we used a similar system, and a group of my patients regularly saw what I wrote about them. I never experienced anything but positives. I recall one patient who was especially interested in knowing all the details of his care and frankly suspicious that I was not telling him everything. Access to my notes reassured him that what I told him was what I wrote and what I thought. We got along well.
The days of doctors as medicine men are over. Patients need navigators, stewards, and advisers. Putting patients and doctors on the same information playing field is long overdue.
Inviting Patients to Read Their Doctors' Notes [Annals of Internal Medicine]
—John Santa M.D.