Whose IV line is it anyway?
The patients overwhelming thought that open visit notes were a great idea. They said it would give them more control and be better prepared for appointments. They also said it would help them do a better job following doctors' orders. More than 37,000 patients took part in the survey, and 92 to 97 percent endorsed access. That's a lot of enthusiasm.
The doctors, however, aren't so sure. Most thought the patients would be more confused and worried if they saw their notes. The doctors also thought they'd have to work more as a result.
About one-third of the 173 doctors polled decided not to take part in the OpenNotes project. For them, the prospect of patients peering over their shoulders meant they would have to be less candid, particularly when writing about such touchy subjects as cancer, obesity, substance abuse and mental health. And unlike the doctors who signed on to the experiment, they didn't think all this hassle would make patient care better or safer.
But for now, here's a clue. In May 2009, the University of Texas M.D. Anderson Cancer Center started letting patients read their electronic medical records online. More than 84 percent of current patients have looked at their records. Referring physicians are using them, too. The two most common requests they make are that doctors fix something written down incorrectly, and for how best to translate medical jargon.
"As a result, they are more informed about their care plan and diagnostic results and ask smarter, more focused questions," Thomas Feeley, vice president of medical operations at M.D. Anderson, and Kenneth Shine, executive vice chancellor for health affairs at the University of Texas system, wrote in an accompanying editorial in Annals. And yes, the doctors do complain about the time it takes to explain what they wrote. But all and all, they're happy with it.