I’ve discussed the push that the government has made to have physicians (and hospitals) adopt health care information systems. As a result, the census of practitioners using these systems has increased from 17% in 2008 to almost 35% by 2011.
And, while the patient would be the owner of that record, in practice, most patients never get a chance to see them. (Now, before you react, think how often you saw your health care records before they became available on computer… Yep, that’s right- NEVER!)
To see what results would occur for both patients and physicians should that fact be changed, The Robert Wood Johnson Foundation sponsored a study ( at a cost of some $1.4 million) at three centers (Geisinger in Pennsylvania, Beth Israel-Deaconness in Boston, and Harborview in Seattle) tested sharing an “OpenNotes” system between patients and practitioners. 105 primary care physicians and 13564 of their patients participated in this study.
Admittedly, some of the invited physicians declined to participate in the experiment. They were worried that sharing notes with patients would “slow them down”; others were worried about legal ramifications. There are some changes effected- because physicians often use jargon (specialized vocabulary) for their own notes; that would not work well for the patients. And, acronyms would not be acceptable (like SOB- no, it’s not what you think, but shortness of breath).
But, some 11800 patients opened at least one note that was found in the system; about half that number (5391) returned online surveys, as well. Of those who returned the surveys, more than 3/4 (77 to 87% of the patients at the three hospitals) felt that this program put them “in the driver’s seat” and made them be more adherent to medication protocols. About 1/3 of the patients reported that they managed their medication protocol and better managed their health care, as a result of being “in the loop”.
Of course, there were a few problems. Some patients wanted to change their record (actually 1/3 of them, but 60% of the respondents thought they should be able to add comments) but the physicians/hospital systems did not allow that practice. About 10% of the physicians needed to spend more time addressing questions (outside of office visits). And, about 1/3 of the practitioners rendered their notes more politically correct (when death with substance abuse, mental health issues, and obesity [high body mass index was used instead of obese]). Other questions arose, such as how to afford the inclusion of older or disabled patients who lacked access to technology.
Interestingly, no physicians left the test protocol, one year into the program. Moreover, this system would have no value for those physicians not employing electronic medical records.
What happens next is the real question…
The Cleveland Clinic, back when my husband and I were going, had on the computer patient files that you could access via log in on the net. Now, they didn’t have it for the Taussig side (the cancer center) but they did in the standard hospital. So if the patient had a test result they could get it off their files which were stored in a searchable way online for them. I personally like this idea (if it is backed up well). I can see the risks of course, hackers and identity theft ect…some privacy concerns of course, so I hope along with the advance there are tools in place to guard against that. Our local GP is moving everything to computer (we went through the basics of it when I took mum to her annual physical). It’s going to be interesting I think, and a positive thing in many ways. Especially if you are traveling and have an accident or some health issue…it will allow doctors access to your files to better understand, treat, and communicate with the people who know you best.
Lisa Brandel recently posted..Only What You See by Lisa Brandel
Yes, Lisa, you gave some great information. The Cleveland Clinic is one of the foremost adopters of useful health care information systems (the other that readily jumps to mind is the Beth Israel system in Boston.)
Thanks for sharing your great experience.
Quite an interesting idea. I would like to be able to see all of my sister’s records from all doctors since they are not in contact with each other. Thanks, Roy.
Ann Mullen recently posted..Senior Care Offers 4 Foods that Lower Blood Pressure
Hmm. I am not sure that you will be able to see your sister’s records, unless you have a durable power of attorney, Ann. That is a protection for your sister…
It will be interesting to see what develops from all this. HIPPA presented a veil of privacy protection, but the signed releases most docs require for accepting insurance coverage around here makes one wonder how private any health data is in the age of the internet. Still, it makes sense that a majority of patients would embrace more open access. It will be interesting to see how this all plays out. Thanks for the reporting, Roy.
Nanette Levin recently posted..Are you on the right trail for small business success?
Oh, Nanette! This was a setup for the post that will appear on Thursday… when you find out what happens with health data you never even consider exists!
Well I think these year, I will be able to become more patient when it come in taking good care of my son. There are times that he always makes me mad when I was working.
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candice michelle recently posted..complementary medicine
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That’s why I write the posts- to keep folks informed about these things.