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A Pioneer Auld Lang Syne

Dec 27, 2012, 11:45 AM, Posted by Brian C. Quinn

Brian Quinn Brian Quinn, assistant vice president, Research and Evaluation

As New Year’s Eve approaches, let’s take a look at a few of Pioneering Ideas’ greatest hits of 2012 one last time.

We rang in 2012 with a post about an idea Steve Downs called simple and dangerous—OpenNotes, an experiment that has enabled patients to read their doctors’ medical notes. We believe OpenNotes has the potential to transform the way patients engage with health care professionals—and take charge of their health.

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Mining a Treasure Trove of Essential Information about People’s Health

Dec 3, 2012, 10:55 AM, Posted by Pioneer Blog Team

Patricia Flatley Brennan, national program director of Project HealthDesign Patricia Flatley Brennan

Over the past seven years, Project HealthDesign supported 14 dedicated research teams in devising fascinating ways to use mobile technology to broaden the patient-provider dialogue and empower patients to manage their health outside of the clinical setting.

In this “tell us your story” feature, National Program Director Patricia Flatley Brennan discusses how through grantees’ work and collaboration, they came to the simple but powerful conclusion that some of the richest and most essential information about people’s health isn’t found at a clinic or hospital: it’s found in their personal attention to the details of their own lives.

Increasing Transparency, Activating Patients: The Case for Open Medical Notes

Oct 11, 2012, 9:12 AM, Posted by Pioneer Blog Team

By Glenn D. Steele Jr., MD, CEO of Geisinger Health System

A group of health leaders, consumer advocates, and medical professionals are gathering in Washington, D.C., today to advance a simple idea that I see as transformational—having doctors make medical notes available to their patients so they can become more engaged in their care. As a health system CEO who also is a doctor, I believe it is an ethical imperative that our patients at Geisinger know everything that we know about them. And, I think it’s a logical imperative that if we can open up our medical visit notes to our patients, we’ll find out what they understand and what they don’t, so we can answer questions and work as partners to chart a path to better health.

The idea of open medical notes is not just an interesting theory. Geisinger just participated in a year-long study called OpenNotes with Beth Israel Deaconess Medical Center in Boston and Harborview Medical Center in Seattle in which more than 100 primary care doctors invited more than 13,000 patients to see their doctors’ notes. The evidence, published last week in the Annals of Internal Medicine, makes clear that open notes is something patients want, something they use, and something that doesn’t unduly burden doctors. In fact, it also is something that could lead to better care and potentially could save health care dollars—as many as 70 percent of patients said that having access to their own visit notes prompted them to adhere to the medications their doctors prescribed.

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Educating Patients—and Ourselves

Oct 9, 2012, 2:18 PM, Posted by Beth Toner

Beth Toner Beth Toner

Last week, I had a flashback to a Saturday night in 2010, when I was in my last semester as a second-career nursing student.

It was a beautiful spring night and my family was gathered around a bonfire in the backyard. I, on the other hand, was sitting at the kitchen table, still in my scrubs. My laptop open, I was staring at the blinking cursor. As usual, I was struggling to finish my “patient database”—my school’s version of a nurse’s note about what happened, clinically, with my assigned patient that day:

1430: Patient received drowsy but AOx3. MAE, equal strength. Primary nurse reports patient requires one-person assist OOB to chair; patient not OOB this shift. PERRLA. Skin is warm & dry, no bruising noted. IV site (20 g left outer forearm) is clean, dry and intact; no pain or erythema noted. Capillary refill <3 sec. Heart sounds audible and regular. Radial and pedal pulses present & equal bilaterally. No edema noted. RR 16, unlabored. SAO2 94% on room air…

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OpenNotes: The Results Are In

Oct 3, 2012, 6:00 PM, Posted by Steve Downs

Steve Downs Steve Downs

Originally posted on The Health Care Blog.

A few years ago, Tom Delbanco and Jan Walker pitched us with a simple idea: Patients should routinely be able to see the notes that physicians write about them.  Now it’s true that we all have the legal right to see these notes, but obtaining them is anything but routine. The process involves phone calls, faxes (sic), duplicating fees and all sorts of other demoralizing steps. The net result is that reviewing your doctor’s notes about you is a rare experience.

Tom and Jan said that the physicians with whom they had spoken about this idea were split. Some were interested, some were resigned: They recognized that transparency was an increasingly powerful wave and that the world seemed to be heading this way, and the others thought they were crazy—notes were for documentation and communication among doctors and were never intended for patients.  The arguments were of a religious quality—they were about belief and values.  The obvious solution was to test the idea and let data help sort it out.  Today, with the publication of the study results in the Annals of Internal Medicine, that debate is now illuminated.

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