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Opening MDs' Notes to Patients Wins Support

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  1. #1
    Donna G Guest

    Default Opening MDs' Notes to Patients Wins Support





    Opening MDs' Notes to Patients Wins Support

    By*David Pittman, Washington Correspondent, MedPage Today

    Published: October 13, 2012

    WASHINGTON -- Patients who viewed their doctors' notes reported feeling
    more in control of their care and practiced better medication adherence,
    a study showed.

    Of the 5,391 patients who completed a post-intervention survey, between
    77% and 87% said it made them feel more in control of their care, Tom
    Delbanco, MD, founding chief of the division of general medicine and
    primary care at Beth Israel Deaconess Medical Center in Boston, and
    colleagues wrote in the Oct. 2 issue of Annals of Internal Medicine.

    Medication adherence increased from 60% to 78%, they reported. But
    between 1% and 8% reported the notes caused confusion, worry, or
    offense, the survey found.

    In all, 105 primary care providers at practices affiliated with
    hospitals in Boston, Seattle, and Danville, Pa., provided patients with
    electronic links to their doctors' notes. Physicians who shared their
    notes with patients through a secure Internet portal reported little or
    no additional volume in patient e-mails, time addressing questions, or
    longer office visits.

    Few of the doctors surveyed at the end of the year-long study reported
    longer patient visits (0% and 5%) or needing more time addressing
    patient questions (0% to 8%), the survey found.

    Buoyed by those results, advocates of opening doctor's notes to
    patients, including Delbanco, are urging the medical community to accept
    the practice.

    And seeing these results as a participating hospital, Beth Israel
    Deaconess Medical Center in Boston is making doctors' notes available
    throughout, it announced Thursday.

    "This is the right thing to do," Kevin Tabb, MD, the hospital's CEO,
    said during a public meeting here. The hospital can separate itself in
    its crowded market by providing the service to patients, Tabb said.

    The move was agreed upon by all department chairs. "I don't think
    anything we've done has been unanimously supported," Tabb said.

    The Annals was hesitant to support Delbanco's study at first because
    results were purely observational and not looking at outcomes, editor
    Christine Laine, MD, said. But after seeing the results, the journal was
    compelled to publish the study and provided the first accompanying
    editorial written by the study's lead author.

    Patients are already granted rights to their medical records through the
    Health Insurance Portability and Accountability Act, but rarely ask for
    them. Physicians also rarely share their notes without patients asking.

    "The concept of open notes requires culture change, and that, no doubt,
    takes time," Delbanco said.

    Physicians may be concerned about privacy breaches and workload issues
    with the open notes concept. But those concerns haven't come to
    fruition, users said.

    "Physicians tend to overrate the risk and underrate the benefits," said
    Steven Stack, MD, emergency physician in Lexington, Ky., and chair of
    the American Medical Association's Board of Trustees.

    Naturally, physicians are concerned with the philosophy initially. "They
    become more comfortable with it" as time goes on, Laine told MedPage
    Today.

    Physicians are more apt to write an explanation of their findings
    knowing patients may read it and, if anything, write clearer notes.

    But further study is needed on how exactly physicians change their
    habits because of note sharing, supporters said.

    Some large and notable medical centers have already taken note of the
    philosophy and implemented it.

    The University of Texas MD Anderson Cancer Center in Houston has had
    open notes since 2009. Tom Feeley, MD, head of the center's
    anesthesiology and critical care division, called it "one of the
    cheapest IT [information technology] projects they did."

    He echoed the sentiment of others: the concept is welcome to patients
    and physicians alike after some initial apprehension.

    The Department of Veterans Affairs with its robust electronic health
    record system is operating a pilot project to expose patients to their
    records. "You're going to see a lot more of this in the future,"
    Delbanco told MedPage
    Today. "We're just starting."

    The project is funded by the Robert Wood Johnson Foundation, the Drane
    Family Fund, the Richard and Florence Koplow Charitable Foundation, and
    the National Cancer Institute.

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!


  2. #2
    Donna G Guest

    Default Re: Opening MDs' Notes to Patients Wins Support





    I think this study is very true.

    Those patients who have access to their medical records, especially
    doctors notes, are more likely to maybe understand their conditions
    better, understand where their doctor is coming from better, and perhaps
    ask more informed questions of their doctors in order to get better
    control of their health issues.

    What are your thoughts on this?

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!


  3. #3
    Harvey Guest

    Default Re: Opening MDs' Notes to Patients Wins Support


    I am sorry but I do not rememvber what was said.
    Harv



    I think this study is very true.

    Those patients who have access to their medical records, especially
    doctors notes, are more likely to maybe understand their conditions
    better, understand where their doctor is coming from better, and perhaps
    ask more informed questions of their doctors in order to get better
    control of their health issues.

    What are your thoughts on this?

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!

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