Open Medical Records

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As you explain your problem to her, your doctor sits at her computer, nods her head and her fingers rapidly click on the keyboard. At the end of your appointment, she gives you a prescription and reviews the details of the medical plan with you. If you are like many people you are left wondering, just what was she typing all that time. Questions such as when I told her how much my arthritis bothers me, did she think I was whining, did she write that in the record, may float through your mind.

What if seeing your medical record was de rigeur? Would health care providers be comfortable with that? Would it change what they wrote? Would it help patient care? And how would patients respond? Would they think it was a good thing?

An experiment in using open medical records was conducted in Indiana recently. Patients were given access to their medical record through a special hospital portal. At the beginning of the trial both medical providers and patients were asked about their feelings regarding patients having unimpeded access to their medical records. Almost 100 percent of patients were trilled about the opportunity to view their record. Health care providers, while generally enthusiastic, had some concerns. They though the record would be confusing to patients, they worried that they would be burdened with extra questions from patients that they didn’t have time for, they were concerned about the extra time it would take to phrase sensitive issues properly.

At the end of the experiment, all the patients were happy and most of the doctors were. A number of positive things happened. Patients felt that they were better able to participate in their care because they had a “hard copy” of what their treatment plan was. They were also able to correct errors in the record in a timely manner. Providers found that the exercise helped them think about how patients feel about sensitive subjects such as obesity. For some patients seeing their diagnoses in writing prompted them to take action to improve their health.

For the most part, the open records didn’t overburden providers. The amount of phone calls didn’t increase substantially, providers didn’t spend significantly greater time writing notes and in many cases they found their patients had a better understanding of what was happening with them medically. At the end of the experiment, most of the health care providers involved elected to continue with the open medical record format.

Of course, access to their medical records has been a patient right for a long time. There are barriers to getting it though. You have to request a copy of your record from the medical records department in writing and you often have to wait to get it. These barriers mean that very few people take advantage of their right. People generally ask to see their medical records when something goes wrong and the medical record becomes fodder for lawyers in a medical malpractice suit. But it doesn’t have to be that way. As the experiment in Indiana shows, there can be a benefit for both patients and providers when medical decision-making is transparent. One could envision a future in which the medical record becomes a shared creation between health care providers and patients.

What do you think of open access medical records?

2 Responses to Open Medical Records

  1. Karen Bell says:

    Patient Gateway is great! Why aren’t you on it? I am mostly @ the Brigham & Mass General for my care. Is it because of the Harvard Teaching Affiliate connection?

    • Nora Saul Nutrition Manager at Joslin says:

      Dear Ms. Bell:
      I agree, Patient Gateway is great. Joslin, however, has its own patient information system, called the Joslin portal. In it you can see your labs and records, have access to educational materials and send your blood glucose records to your provider in a secure fashion. If you are not enrolled, please provide Joslin (by calling 617-309-2400) with your email address. After being set up in the portal, you should get a email with a set of welcome instructions.

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