Wednesday, October 28, 2009

Access to Physicians Notes

Patients and consumers across the country are voicing a growing interest in having more control over their own medical care. Geisinger Health System is a participant in a new study to examine the impact of adding a new layer of openness so that patients will have access to the notes from their doctor visits. Patients do have the legal right to obtain their paper records, which usually includes notes, but very often they have to wait to get copies and must pay a fee. Online access would be quick, easy, and free.

The Journal of General Internal Medicine reports that consumers want full access to all of their medical records and they are willing to make some privacy concessions in the interest of making their medical records completely transparent.

The 12-month OpenNotes © Project is being funded by a $1.4 million grant from the Robert Wood Johnson Foundation (RWJF) Pioneer Portfolio. The project will bring together 100 primary care doctors and 25,000 patients to evaluate the impact on both patients and physicians when sharing the comments and observations made by physicians after each patient encounter.

The study is being led by Boston’s Beth Israel Deaconess Medical Center and includes primary care physicians and patients at Geisinger and at the Harborview Medical Center in Seattle. Researchers hope to learn whether the increased transparency will increase patient-physician trust and communications and whether it will help patients to manage their own care better.

By early next year, the Geisinger team hopes to provide several thousand patients who use the “MyGeisinger” web portal with online access to their primary care physician’s notes. Patients will receive reminder e-mails that the notes are accessible. By contrasting the experience of trial participants with non-enrolled physicians and patients, the researchers hope to measure the impact access to the notes has on patients’ engagement in their care.

According to Jonathan Darer, M.D., Geisinger’s lead investigator on the project, patients generally retain only a portion of the information that is exchanged with their doctor. While some doctors have been quick to sign up, others are more pragmatic and worry that the notes could be misinterpreted and create more communication issues than they solve.