Health IT, Hospitals, Patient Engagement

Trends in healthcare: Giving access to doctor notes can stimulate patient engagement

The prospect of giving patients access to their doctors’ notes has been viewed with a […]

The prospect of giving patients access to their doctors’ notes has been viewed with a mixture of enthusiasm and angst both by doctors and patients. Patients who might welcome more information may also have concerns over the privacy of that information. Alternatively, doctors who want greater adherence from patients may also be concerned about how patients interpret their notes. But here’s the mystery: What will both sides do with the new information that may arise from more transparency?

A survey stemming from the Open Notes project — initiated in 2010 — showed that in the early days of transparency, there are limits to patients’ interest in this additional information, but there are also  benefits for those who relish the new transparency, according to a New England Journal of Medicine article

More than 100 primary care doctors at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Northeast Pennsylvania, and Harborview Medical Center (a Seattle safety-net hospital), volunteered to invite 20,000 of their patients to read their notes securely online. Currently, 2 million patients have access to their doctors’ notes.

Disappointingly, only “a small minority” of these doctors’ patients used the portals. Still, the initial findings showed that after one year, four of five patients had read the notes. Many of them reported having better recall and understanding of their care plans and feeling more in control of their healthcare.  In what’s likely to resonate the most, two-thirds of patients who were taking medications reported improved adherence.

Doctors reported little effect on their work lives and were surprised by how few patients appeared troubled by what they read, according to the article. Although most of the doctors said they had not changed the tone or content of their notes, some said they changed the way they worded cases dealing with cancer, mental health, substance abuse and obesity. After the first year, 99 percent of the patients who responded to the survey said they wanted the access to their doctors’ notes about them to continue. About 85 percent  said access to physician notes would be important for their future choice of a provider.

To be clear, patients’ access to doctors’ notes  is generally limited to ambulatory care. Even though most survey respondents said they want access to inpatient notes, the authors conclude that offering this kind of access in acute care hospitals would be particularly complex, “since a patient’s status may fluctuate, multiple clinicians may offer opinions, and plans may change frequently.”

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