Sharing electronic records with patients gains traction, raises new concerns

More hospitals and physicians are choosing to provide their patients with access to their electronic records, but the practice is also raising new controversies, according to a recent article on National Public Radio.

In the article, Leana Wen, director of patient-centered care research in the department of emergency medicine at George Washington University, points out that sharing notes with patients has been a positive experience, enabling her to correct errors caught by patients' review of the records and providing information that helps her diagnose conditions more quickly. The access also increases trust.

She additionally reports that the OpenNotes program--which began as an experimental program among Boston-based Beth Israel Deaconess Medical Center, Geisinger Health System and Harborview Medical Center in Washington state several years ago--has been so successful that it has spread to other health systems. The U.S. Department of Veterans Affairs also shares the data from its EHR system with its patients.

BIDMC earlier this year expanded the OpenNotes program further by allowing patients to access their mental health notes.

However, the trend, which has been predicted to become the standard of care, is not without unintended consequences and new "side effects." For example, questions have emerged regarding how much of the mental health notes a patient should have access to and how to deal with patients who post their records on social media.

And in research published last fall about OpenNotes, nearly one-third of more than 3,800 patients participating in the program reported concerns about privacy before beginning; close to 37 percent expressed concern about privacy after the intervention. The level of concern among most participants did not change during the intervention, but 15.5 percent reported more concern post-intervention, and 12.7 percent reported less concern.

Providing patients with access to their notes is one way to further patient engagement, one of the current buzz phrases in the industry. Patient engagement is also a primary tenet of the Meaningful Use program.

To learn more:
- read the NPR article