Now Viewing: Transparency/public reporting

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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Taking Note

Jun 12, 2012, 2:00 PM, Posted by Pioneer Blog Team

Suzanne Mintz, President and CEO of the National Family Caregivers Association

Nearly one third of adults in the U.S. provide care for a chronically ill, disabled or aged family member or friend during any given year, spending an average of 20 hours per week providing care for their loved one. Many are responsible for helping coordinate their loved one’s medical care—keeping track of doctor’s appointments, reminding care recipients to take medications and monitoring their overall health.

Asking patients to share doctors’ notes with their family caregivers can help caregivers be more effective in this role. It can also help both patient and caregiver feel more in control and allow them to more fully engage in health care decisions. Yet few patients act on their right to access and share their doctors’ notes, lab test results and other information contained in medical records.

Reminding women—who so often play the role of family caregiver and drive health care decisions in families—that this resource is available and encouraging them to ask doctors for copies of their notes is critical. That’s why I was so pleased to read about OpenNotes in the May issue of the magazine Redbook.

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Making Sense of the Debate Over Patient Access to Medical Information

Feb 16, 2012, 11:33 AM, Posted by Pioneer Blog Team

Lately, there’s been a lot of conversation about increasing patient access to medical information. Much of this debate was sparked when Kathleen Sebelius, secretary of the Department of Health and Human Services, stated, “When it comes to health care, information is power.” While many providers and most patients are in support of increasing patient access to medical information, there are some who feel this change will make doctors’ jobs harder.

OpenNotes, a Pioneer-supported program that makes it easy for patients to access their doctors’ notes after a visit, is at the heart of this debate, as was seen in a series of columns in February’s SGIM Forum. In this newsletter Tom Delbanco, MD,  and Jan Walker, RN, MBA,  the lead investigators working to determine the impact of sharing doctors’ notes with patients (Part 1),  debate the merits of this new level of transparency  with Douglas Olson, MD (Part 2), and well-known patient advocate e-Patient Dave (Part 3).

In a post on The Health Care Blog, John Lumpkin, MD, MPH, senior vice president and director of the Health Care Group at RWJF, weighs in on this debate.  Learn why Lumpkin thinks that increasing access is a good idea and tell us what you think.