News Feature | December 30, 2013

Physician Note Transparency Embraced By Patients

Source: Health IT Outcomes
Katie Wike

By Katie Wike, contributing writer

HTO Dictating Doctor

Allowing patients and their families’ access to doctors’ notes could improve accuracy and safety according to several participants in the Open Notes Program

The Open Notes Program, an experimental initiative, is exploring the effects of providing access to doctors’ notes. According to an article in the New England Journal of Medicine, beginning in 2010, more than 100 PCPs volunteered to provide their notes to patients online. “At the end of a year, four of five patients had read the notes, and among those who responded to a survey, large majorities reported having better recall and understanding of their care plans and feeling more in control of their health care,” notes the report.

In addition, “Two-thirds of patients who were taking medications reported improved adherence.” Doctors were surprised how little allowing such access affected their days and many expected patients to be concerned with what they read but were pleasantly surprised to find they were not.

This does, however, mean clinicians need to be more careful in their notations. As the study found, it was difficult for physicians to write about a suspicion of cancer or disease and a touchy subject to address character disorders or cognitive dysfunctions. This is one reason many physicians who participated in the experiment said they would prefer to be able to hide portions of the record.

David Levin, M.D., CMIO of the Cleveland Clinic, told FierceHealthIT in a recent interview that transparency is working for his organization. Office notes are available through patient portals and hospital notes will be accessible soon.

Levin told Fierce EMR. "We're actually finding patients help us fill in gaps in the record and find errors in the record. And I know that makes some people queasy; but we think this is a boon for patient safety. The position I take is the error is already there. This is about all of us working together to correct it."

Ninety-nine percent of the patients who participated said they would like transparency to continue, and they reported feelings of greater control and understanding of their medical records. The study’s authors admit there is some work to be done to satisfy both patient and physician needs in the quest for transparency, but also concluded, “Open notes can help improve patient safety by allowing contributions from patients and families who may catch questionable statements or clinically important mistakes in notes or find lapses in follow-up that need to be rectified.”

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