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Survey Says: Patients Excited, Physicians Hesitant About Open-Access to Medical Notes

February 16, 2012

Patients want to see their doctors’ notes. Some doctors aren’t so sure that’s a good idea. According to two family physicians who have embraced the practice, however, it’s a no-brainer, according to a report by the American Academy of Family Physicians.

Researchers at three hospitals participating in the OpenNotes pilot — Boston’s Beth Israel Deaconess Medical Center (BIDMC), Harborview Medical Center in Seattle and Geisinger Health System in Pennsylvania — surveyed 173 primary care physicians and 38,000 patients during the sign-up phase of the 12-month pilot, which launched in summer 2010. Survey respondents included both physicians who volunteered to participate in OpenNotes and those who declined to participate, as well as patients cared for by both groups of physicians.

The survey findings, which were published in the Annals of Internal Medicine, shows that patients “expressed considerable enthusiasm and few fears (about viewing the notes), anticipating both improved understanding and more involvement in care.” Physicians, on the other hand, “varied widely” in their predictions about how opening up visit notes would affect their practices and their patients and pointed out that sharing visit notes has broad implications for quality of care, privacy and shared accountability, the report said.

A recent announcement from the study authors indicated that although many of the primary care doctors who volunteered to participate in OpenNotes predicted possible health benefits, the balance of those who chose not to participate voiced doubts about positive impacts.

“Among the 173 doctors completing surveys, the majority expressed concerns about confusing or worrying patients with the content,” the authors said. “Doctors also anticipated that they would write their notes less candidly and that responding to patient questions might be exceedingly time-consuming.”

The results of baseline surveys conducted before the launch of a yearlong pilot designed to explore the pros and cons of giving patients open access to their physicians’ medical notes show that patients enthusiastically supported the idea. Their physicians, however, seemed dubious about the effects of such transparency
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