Transparency in health care can bring greater empowerment and enable more rational decision making for health consumers. Physicians acknowledge this: “We believe that increasing transparency in the health care system can be beneficial to both patients and physicians,” said J. Fred Raslton, Jr., MD, FACP, president of the American College of Physicians.
There’s an indication that patients will embrace transparency in the form of accessing their physicians’ notes about them, based on the OpenNotes project research published in the Annals of Internal Medicine this week.
The objective of the study was to measure the impact on doctors and patients of extending patients access to view their doctors’ notes over a secure Internet portal. The trial was done at three medical centers: Beth Israel Deaconess Medical Center in Massachusetts, Geisinger Health System in Pennsylvania, and Harborview Medical Center in Washington state. Some 13,564 patients and 105 primary care providers were involved in the study.
The finding that virtually all patients involved wanted to continue to have access to doctor’s notes is significant. However, even more powerful is that 62% of patients would like to be able to add comments to doctors’ notes, which one-third of doctors said would also be useful. One in 3 patients believe they should be entitled to “approve” the notes’ content; few physicians thought so.
A majority of patients agreed that OpenNotes could have many benefits for them, including taking better care of self, understanding health conditions, remembering care plans better, preparing for visits more effectively, feeling more in control of their care, and taking medications better. Fewer than one-half of physicians agreed that these potential benefits would accrue to patients.
Nonetheless, most physicians agreed that nothing was difficult about the OpenNotes program and they experienced no changes in their practice (such as workflow interruptions and productivity loss).
Health Populi’s Hot Points: “We suspect that fear or uncertainty of what is in the doctor’s ‘black box’ may engender far more anxiety than what is actually written, and patients who are especially likely to react negatively to notes may self-select not to read them.”
For those patients who want to health-engage, the OpenNotes project gives credence to the fact that patients can handle the truth. (Cut here to Jack Nicholson and Tom Cruise in A Few Good Men). Beyond “reading” notes is the transformation that can happen within a patient on the journey toward empowerment: the researchers point to a quote from a patient focus group: “Having it written down, it’s almost like there’s another person telling you to take your meds.”
Thus begins the virtuous cycle of communication in the healthcare transparency ecosystem. Transparency brings enlightenment and empowerment in health care.