New York Times
columnist Pauline Chen, MD, recently wrote
about whether patients should have easy access to their medical records. Of
course, HIPAA guarantees that all patients have the right to access and amend their
medical record; however, this is often easier said than done.
Fundamental questions about the value of sharing medical
records with patients remain, Chen writes. “Should medical records be shared as
interactive documents between patients and physicians? Can transparency work,
or will it end up worrying patients, muddling the patient-doctor relationship
and adding more work to an already overburdened primary care work force?”
To help answer these questions, several health centers are
taking part in a study
that examines the effects of providing access to physician notes to
patients. In the study, patients receive
an e-mail sending them to a website to view their physician’s notes after the
visit and a reminder prior to a follow-up visit that the notes are available
for review. The study has more than 100 participating physicians and 25,000
patients. According to lead investigator of the study Jan Walker, RN, finding
physicians to participate in the study has been challenging, while finding
patients has been much easier. Walker says that many physicians feel
overburdened and are worried about the clarity of their notes.
At Kaiser Permanente where I work, we provide HIPAA compliant electronic
access for our patients to access their own results of lab values and tests
once they have been screened and reviewed by the ordering physician. Our own
electronic record also has an interactive component through “e-secure,” which
is an HIPAA compliant confidential email communication portal between the
physician and the patient.
Since we’ve put this into place, I’ve noticed a markedly enhanced
patient satisfaction in their patient-physician relationship. The emails are
limited in words allowed and no attachments can be sent by the patients. My own
experience is that patients do not “abuse” this email portal and that my care
delivery is actually made substantially more efficient rather than playing
“phone tag”. The interactions become part of the medical record documenting the
care and advice given. At the present
time, however, the patient is still required to submit written authorization
for a hard copy of their own electronic health record at Kaiser Permanente.
What do you think of
regularly sharing your notes with your patients? Do you think this would
have negative or positive outcomes for your patients or yourself?