Docs push open-notes policy

Physicians may be reluctant to share their notes openly with patients, according to a study published in the Annals of Internal Medicine that we reported on last month. Once they try it, however, they seem to like it. 

A pair of articles from the Houston Chronicle and Kaiser Health News this week dug deeper into the providers' perspective on open-notes policies. What they found was bit surprising. 

First, the hospitals that participated in the Beth Israel Deaconess Medical Center-run study seemed to be open-notes converts. The three facilities--based in Boston, Seattle and rural Pennsylvania--all have decided to keep their open-notes policies in place, even now that the clinical study is completed, the Chronicle reported.

Second, a group of Texas hospitals that didn't participate in the study came to light as having quietly worked to broaden the open-notes movement for more than three years. University of Texas' M.D. Anderson Cancer Center has had online portals allowing patients to access typed notes from their physician visits since 2009. It has become so popular, the program now is being expanded to all six UT health campuses, according to the Chronicle

The hospital's real-life experience with open-notes backs up the study's findings, according to two M.D. Anderson physicians who contributed a supporting editorial to the study. For example, doctors in the study worried that allowing patients to dig through their notes would prompt a plethora of follow-up questions, and require excessive follow-up time. M.D. Anderson physician and editorial co-author Thomas Feeley's response: Follow-up questions actually declined as patients were able to read about their condition for themselves.

"There have been no adverse consequences and generally positive feedback from patients and physicians," Feeley and the UT System physician Kenneth Shine said. "[Patients] are more informed about their care plan and diagnostic results and ask smarter, more focused questions." 

And whether they like it or not, physician may have to adjust to more patient access to clinical data. The U.S. Department of Health & Human Services proposed a rule last fall that would give all patients direct access to their lab test results. The comment period ended in November 2011, and although there's no release date set for the final rule, it's certainly looming. 

To learn more:
- read the Houston Chronicle article
- dig into the Kaiser Health News piece
- check out the original AIM study 

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