Earlier this year, the Department of Veterans Affairs (VA) embraced OpenNotes, enabling more than 1 million veterans who currently have access to the VA personal health record to view or download their own medical notes along with their health record information via the My HealtheVet Blue Button. In a recently published study in the Journal of Medical Internet Research (JMIR), the VA's Susan Woods, MD, MPH, a longtime champion of open access and transparency, examined patients’ views and experiences with reading their health records, including clinical notes. The study is the first qualitative look at VA patients’ experiences viewing electronic records that included clinical notes and lab test results. Woods and her colleagues showed that viewing records and notes appeared to empower patients and increase their involvement in their own care but Woods says new communication skills will be needed to optimize the user experience.

In a recent interview, Woods discussed the power of open medical notes for patients and clinicians.   

In a recent post in The Health Care Blog, Archimedes Founder David Eddy, MD, makes a strong case for the new Global Cardiovascular Risk score (GCVR), because it will keep providers more focused on preventing disease and give them a more accurate and meaningful target to shoot for to keep patients healthy. This project, to test the merits of a new way to measure the health outcomes of patients with heart disease and diabetes, is an example of a truly disruptive innovation that could be a real game-changer for measuring quality. Read Dr. Eddy’s full post below.

-Nancy Barrand  

Dr. Darwin Labarthe, Positive Health researcher and former director of the Division for Heart Disease and Stroke Prevention with the Centers for Disease Control and Prevention (CDC), recently wrote an essay about the shift in the field of cardiology to focus on building cardiovascular health—beyond just preventing heart disease, stroke, and other cardiovascular events. Labarthe is part of an increasing number of experts in the health and health care communities who are focusing on health assets—strengths that can contribute to a healthier, longer life. This new framework is increasingly referred to as Positive Health, founded by Dr. Martin Seligman, Pioneer grantee and director of the Positive Psychology Center at the University of Pennsylvania. Below, Labarthe explains this shift, which he considers revolutionary, and places it in historical context.

By Darwin Labarthe, MD, MPH, PhD

Public health has seen three distinct revolutions. The first, more than a century ago, addressed communicable diseases. The second was heralded by the 1979 launch of Healthy People, the United States’ science-based initiative. Healthy People shifted the focus of the Department of Health, Education and Welfare (now Health and Human Services) from its longstanding emphasis on disease prevention to health promotion, defined by the World Health Organization (WHO) as “the process of enabling people to increase control over, and to improve, their health.” Finally, in 1986, WHO’s Ottawa Charter for Health Promotion triggered what some consider the “wellness revolution,” emphasizing that health was “a resource for everyday life, not the objective of living.” In other words, it advanced the notion that health was about more than the absence of disease, or staying alive—it was about thriving.

In my essay, I wrote about a current shift in focus from cardiovascular disease to cardiovascular health. I would posit that this may portend a broader fourth revolution: a “positive health” revolution.

Wall Street Journal reporter Laura Landro’s recent interview with a front-line doctor underscores why we need more meaningful ways to measure quality. Mayo Clinic’s Dr. Victor Montori, who specializes in treating people with chronic illnesses, says health care systems and doctors are not being rewarded for preventing disease and instead pressured to satisfy measures that mean little for patients or health.

A recent report found "most family doctors" in the United Kingdom have given a patient a placebo.

And why not?, asks Phillipa Perry in The Guardian — after all, "a placebo is an effective, proven intervention that stimulates our bodies' own capacity to heal itself."

The answer to Perry’s question, some might argue, is deception — doctors shouldn’t lie to their patients. But what if deception wasn’t necessary for a placebo to work? What if you could tell someone you were giving them a placebo, and it could still improve their symptoms?

This idea is at the heart of Pioneer grantee Ted Kaptchuk's research at Harvard's Program in Placebo Studies and the Therapeutic Encounter (PiPS), the first multidisciplinary institute dedicated to studying placebos.