With the increasing digitization of health records, it becomes much easier for patients to view physician’s notes on their conditions and treatments, if they are permitted to do so. Concerns have been expressed about the potential adverse effects of such access on the quality and completeness of the doctor’s charting and on the patient’s perception of their relationship with their physician and/or their medical state. Research reported in the Annals of Internal Medicine looked at about 13,560 patients of 105 physicians at three large medical centers to see if giving those patients access to notes had noticeable effects on outcomes. (Annals Article) Almost 11,800 of the patients opened at least one note and of these about 5400 completed surveys. Please note that the results of the study are all self-reported and often subjective.
About 80% of the patients said that seeing the notes helped them feel more in control of their care, about 75% said it improved medication adherence, around 30% had privacy concerns, a very small percent said the notes caused anxiety or confusion and around 30% shared the notes with others. Patients who saw the notes did not send more messages to the doctors and the length of doctor visits was basically unchanged. As many as a third of doctors, however, did change the content of their documentation. About 60% of patients wanted to be able to add comments to the notes the physician wrote. Almost a third wanted to be able to approve notes, but as would be expected, doctors strongly disagreed. Almost all patients wanted to continue to have access to the notes at the end of the study period. Before we get too excited about this practice, it might be nice to have some real evidence about effects on outcomes and on work processes for providers.