For pa­tients to be ac­tive part­ners in their own care, they need quick ac­cess to their per­sonal med­i­cal in­for­ma­tion.

Modern Healthcare - - OPINIONS COMMENTARY -

in three very dif­fer­ent set­tings: an ur­ban teach­ing hos­pi­tal and as­so­ci­ated com­mu­ni­ty­based prac­tices (Beth Is­rael Dea­coness Med­i­cal Cen­ter in Bos­ton), pri­mar­ily ru­ral prac­tices (Geisinger Health Sys­tem in Danville, Pa.), and clin­ics at a safety net ur­ban hos­pi­tal (Har­borview Med­i­cal Cen­ter in Seat­tle). We are learn­ing that pa­tients are over­whelm­ingly in­ter­ested in gain­ing rapid ac­cess to their notes and that many doc­tors ap­pre­ci­ate the po­ten­tial for open records to im­prove care.

The en­thu­si­asm of pa­tients ap­pears to cut across all lines of age, health sta­tus and ed­u­ca­tion. And while many doc­tors turned down our in­vi­ta­tion to join the one-year project, cit­ing fears that their notes would ad­versely af­fect their al­ready oner­ous work flow and frighten or con­fuse pa­tients, only one doc­tor who signed up for the study later dropped out, and that was for per­sonal rea­sons.

More­over, hall­way con­ver­sa­tions in­di­cate that doc­tors have not ex­pe­ri­enced sig­nif­i­cant dis­rup­tions to their work, an im­pres­sion con­sis­tent with sev­eral ear­lier, al­beit smaller stud­ies fo­cus­ing on sub­spe­cial­ists car­ing for pa­tients with di­a­betes or heart fail­ure. One doc­tor who was ini­tially very hes­i­tant told us re­cently that she feels “much safer” with her pa­tients re­view­ing what she writes, and oth­ers Dr. Tom Del­banco and Jan Walker are clin­i­cians at Beth Is­rael Dea­coness Med­i­cal Cen­ter, Bos­ton, and teach at Har­vard Med­i­cal School.

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