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OpenNotes research into opening EMRs to patient viewing

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I was on a particularly stimulating Twitter Chat session today with the #HPM (Hospice and Palliative Medicine) group.  During the session Christian Sinclair introduced the chat topic

Recent program called OpenNotes got some press. Patients can see their medical record. How should hospices approach this?

Katerina mentioned the project in one of her earliest posts back in July. Thus, just to remind OpenNotes is a “demonstration and evaluation project exploring what happens when the medical record becomes far more transparent than in the past.”

Now, from LHD’s point of view open-ness and transparency is a critical part of patient-centered medicine.  The ability for a patient and her carers to choose whether or not to read the doctor’s medical notes is what matters. Technically the linking of computer systems with external email and in a secure environment may make rolling out a program like this expensive.

Fact: some people want to be more engaged with their health than others.

The Researchers elaborate further on their underlying hopes for the study

OpenNotes is a simple, but potentially disruptive intervention that aims to transform the patient-clinician relationship as it furthers both transparency and the democratization of health care. The “bottom line” evaluation of OpenNotes is straightforward: Will patients and doctors want to continue when the study period ends?

Some of the issues which this raises are

  • should the doctor write in a different manner because the notes may be read by a layman
  • will this raise the time doctors spend on documentation
  • will this create greater engagement by the patient and her carers in the treatment
  • can this new channel of communication ease the administrative burden on doctors

What will be interesting is whether there is any variation in the research findings from the three different hospitals selected for the study.  I am glad that it’s planned to be a long term study running for over a year and the researchers are actively encouraging the public to contribute their views.  The research methodology summary.

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