I walked out of my doctor's office with a handful of papers following a routine appointment this week. There was nothing unusual about that. I always request a copy of any test results; there is usually an order for more bloodwork to be done prior to my next appointment; and there's always a prescription for my pain medication, which cannot be sent to the pharmacy electronically.
But that day, my little pile of paperwork seemed thicker than usual. As I sorted through the papers, I noticed something new––a printout of the notes my doctor had made during my visit. Actually, it was more than that. In addition to the current notes, there was a nice little summary of my medical history, including the dates of surgeries, vaccinations, lab tests, etc.
Having this information in print right in front of me gave me a feeling of empowerment. There is typically a significant amount of information shared during a doctor appointment––symptoms and problems I tell her and recommendations she makes to me. Even though I try to write down what she tells me, it's very easy to misunderstand or forget something. Having her notes gives me the opportunity to double check and make sure we understood one another. It also serves as a nice reminder for me so I don't forget things she's asked me to do––like monitor my blood pressure regularly or check my blood glucose more often.
Study Shows Access Helps Patients Feel in Control
Apparently I'm not the only one who likes having access to my doctor's notes. A study published in the October 2, 2012 issue of the Annals of Internal Medicine found that from 77% to 87% of participants “reported that open notes helped them feel more in control of their care.”
Study Design and Results
The study was conducted at three primary care facilities, one in each of three different states (Massachusetts, Pennsylvania and Washington). A total of 105 primary care physicians and 13,564 patients participated in the year-long project.
During the study period, participating patients were offered access to their doctor's notes through secure electronic portals. Of the patients invited to participate, 11,797 (87%) opened at least one note and 5,391 completed a survey at the end of the study. In addition to feeling more in control of their care:
60% to 78% of those taking medications reported increased medication adherence.
26% to 36% had privacy concerns.
20% to 42% reported sharing notes with others.
1% to 8% reported that the notes caused confusion, worry, or offense.
Looking ahead, 59% to 62% of patients believed that they should be able to add comments to a doctor's note. One out of 3 patients believed that they should be able to approve the notes' contents, but 85% to 96% of doctors did not agree.
Interestingly, at the end of the study period, 99% of patients wanted open access to their doctors' notes to continue and none of the doctors elected to stop providing that access.
Whether the notes are printed out as my doctor does or made available electronically as in this study, I think giving patients access to their doctors' notes is a great idea. I believe it will lead to more accurate medical records which should ultimately result in better care.
Of course, privacy and security are always a concern, but since the Affordable Care Act is requiring physicians to keep electronic records anyway, I doubt that giving each patient access to his/her own personal medical records would put our privacy in any greater jeopardy.
Although under HIPAA laws we already have the right to see our medical records, very few of us exercise that right unless there is some kind of problem. I hope more doctors will begin giving their patients routine access to their medical records.
How do you feel about this issue? Does your doctor give you copies of or access to her notes following an appointment? If so, do you like that? If not, would you like her to?
Delbanco T, Walker, J, et al. Inviting patients to read their doctors' notes: A quasi-experimental study and a look ahead. Ann Intern Med. 2 October 2012;157(7):461-470.