PHRs:Patients Want To Read Doctors' Notes, But Many Doctors Balk

From NPR News:

Doctors write about their patients all the time, in notes detailing office visits and treatments. But for patients, those notes are a closed book.

Maybe the doctor has scribbled that the patient was "difficult," as Elaine discovered when she peeked at her chart in a memorable Seinfeld episode. When her dermatologist saw her snooping, he grabbed the chart out of her hands.

Well, patients seem ready to take that risk. When asked if they'd like to see their doctors' notes, patients in two new studies overwhelmingly say yes. But doctors aren't nearly as enthusiastic.

 

The idea of opening up doctor's notes has been around for decades. Advocates figure that patient oversight will reduce medical errors and help patients be more engaged. Patients have a legal right to see their records. But actually getting those notes can be expensive and slow.

Doctors and hospitals can charge whatever they want for photocopying, and can take up to two months to deliver. (Patient advocate Regina Holliday was charged 73 cents a page when she asked for copies of her husband's chart when he was dying of cancer.)

Now that doctors and hospitals are using electronic medical personal health records (PHRs), however, the process of sharing should be relatively cheap and convenient. These two surveys asked doctors and patients if they are ready to make that leap.

The first survey asked 18,741 patients of the Department of Veterans Affairs health system if they'd like to share their online personal health record with family members or other doctors. Seventy-nine percent said they would. The patients were almost all men over age 50. Many were in poor health. (Some personal health records include doctor's notes; many do not.)

But it's the second survey that really gets at the conflict over control of the medical record. It's a poll taken at the very start of OpenNotes, a yearlong experiment that aimed to measure benefits and problems when doctors let patients read their notes. (OpenNotes is funded by the Robert Wood Johnson Foundation, which also is an underwriter of NPR.) Both studies were published in the Annals of Internal Medicine.