Tuesday, October 2, 2012

Access to Doctors' Notes Aids Patients' Treatment

Access to Doctors' Notes Aids Patients' Treatment
Wall Street Journal
October 1, 2012

Patients who have access to doctor's notes in their medical records are more likely to understand their health issues, recall what the doctor told them and take their medications as prescribed, according to a study published Monday.

The study, published online in the Annals of Internal Medicine, is the culmination of an experiment known as OpenNotes, an effort to improve doctor-patient communication by letting patients know everything their doctor has to say about them, including after a visit.

Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle took part in the trial, which included 105 primary-care doctors and 13,564 of their patients who had at least one note available to them during the voluntary program.

While patients legally have the right to see their entire medical record, including doctor's notes, the notes aren't automatically included in requests for records and doctors don't make it easy for patients to see them, says Tom Delbanco, a primary-care doctor at Beth Israel who is co-lead author of the study and a professor at Harvard Medical School. Some doctors were initially resistant to the idea of sharing notes, he says. According to the study, doctors who declined to participate expressed concerns that their workflow might be disrupted and that they might scare or offend patients.

But the study, based on surveys of doctors and patients taken in fall 2011 after 12 to 19 months of participation, found most fears weren't realized, and patients were enthusiastic about accessing the notes.

Close to 11,800 patients opened at least one note contained in their electronic medical record. Of 5,391 patients who opened at least one note and returned online surveys, 77% to 87% across the three sites reported that OpenNotes made them feel more in control of their care and more adherent to medications...

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