If you read the Klick Wire you’ll have already seen the story about a study at three hospitals in the US that provided physician notes to patients to determine the uptake. The results are published in the Annals of Internal Medicine and they show a hunger for access in the patient population.
Some details of the study:
- 11,797 of 13,564 (87%) patients with visit notes available opened at least 1 note
- 77% to 87% across the 3 sites reported that open notes helped them feel more in control of their care
- 60% to 78% of those taking medications reported increased medication adherence
- 1% to 8% reported that the notes caused confusion, worry, or offense
- 20% to 42% reported sharing notes with others
- 59% to 62% of patients believed that they should be able to add comments to a doctor’s note
- At the end of the experimental period, 99% of patients wanted open notes to continue and no doctor elected to stop
There are a few findings here that are of note and I’ll tackle them in the order of my view of their importance to the practice of medicine. The last finding is probably the most telling—no one wanted to stop: neither the patients nor the doctors. When given the right tools to communicate, there are no barriers.
Let me state that again. When given the right tools to communicate, there are no barriers.
There are so many people in the healthcare system that need to hear this message, and so many willing to carry it (I’m looking at you, e-patient Dave deBronkart, Stupid Cancer Matthew Zachary, and lung transplant
e-patient e-diva Charity Sunshine Tillemann-Dick).
The doctors need to know it so they can express their support. The patients need to know about it so they can demand their (damn) data, finally, the administrators who control the budgets need to recognize that data access isn’t a cost, it’s a savings.
Educated patients who understand their diagnosis and treatment aren’t extra burden on the system, they are willing partners in cost savings. Look at the adherence numbers above… Up to ¾ of the participants in the study report better medication adherence. This saves money on the system with fewer emergency room visits and either faster recovery or better control of chronic conditions.
Are patients just lawsuits waiting to happen? Apparently not. Only 1-8 percent were confused or offended. The doctors probably do a better job of communicating when they know the patients can look up the information later. And the patients do a better job of listening because they can concentrate on what matters, knowing that the details are available 24/7 on the internet.
Better adherence, lower confusion and errors, more engagement, less cost.
The only question is how quickly can we expand this program from this study to every hospital and clinic in the country.
What reasons can you see for this not happening? Are there issues that will keep this technology from patients across the nation?