Journal of Nursing
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Online Access to Notes on Patients Gets Mixed Reviews

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SAUSALITO, CA (ASRN.ORG) -- Patients and doctors have dramatically different visions about the value of access to physicians' notes about their patients, a new survey from Harvard Medical School released Monday shows.

The study, showed that 80% of doctors surveyed worried their patients aren't educated enough to understand their notes freely available online, while 80% of patients say the information will empower them to take charge of their health.

Researchers say the difference represents a generations-long history of doctors telling patients what to do, and to patients listening to but not questioning that advice, a patriarchal system that assumes the doctor knows best.

"This will change a lot of people's perceptions of patients," said Jan Walker, lead author for the study out Monday. "The level of enthusiasm from the patients was mind-boggling."

Patients overwhelmingly favor access to doctors' records, researchers found, including:

•Ninety-four percent believed the records should be available.

•Ninety percent said the information would give them more control.

•Eighty percent said they would take better care of themselves because of the information.

•More than half said the information would help them take their medication properly.

Doctors, on the other hand, worried access to their notes would confuse patients, that it would not benefit them because they would not change their behavior, and that it would lead to such an influx of phone calls and concerns that their practices would be overwhelmed, said senior author Tom Delbanco.

And, as many as 80% of the surveyed doctors said they were frightened by the idea of allowing the records to be accessible.

"Doctors just kind of underestimate patients," said Delbanco, who is also a doctor at Beth Israel Deaconess Medical Center. "We sometimes sell them short."

Walker and Delbanco led a team that surveyed 38,000 patients from several medical centers around the country, as well as 173 doctors. The doctors were also asked to participate in the study by placing their doctors' notes online for patients to access freely. About 70 doctors refused that portion of the study.

The survey's finding could help save money, Delbanco said. If patients take better care of themselves after seeing the notes, that would cost the health care system less money. The study also comes as the Obama administration has created $27 billion in incentive payments to encourage electronic health records.

In the past, patients could legally get their records, but Walker said many patients either did not know or found the process expensive and tedious.

The survey revealed a general concern among physicians that patients would not understand the information they could learn.

Another fear came from patients second-guessing their doctors. Patients could post the notes on social media sites and ask, "What do you think about this?" Delbanco said.

"It could make some doctors very nervous," he said.

Next, the researchers will look at how many patients looked at the data over the past year, how it affected them, how many phone calls the doctors received and whether patients and doctors changed their behaviors.

When given the choice about whether to keep posting their records online for additional research, none of the doctors dropped out of the study, Delbanco said.

 

Copyright 2011- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved 



 
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Editor-in Chief:
Kirsten Nicole

Editorial Staff:
Kirsten Nicole
Stan Kenyon
Robyn Bowman
Kimberly McNabb
Lisa Gordon
Stephanie Robinson

Contributors:
Kirsten Nicole
Stan Kenyon
Liz Di Bernardo
Cris Lobato
Elisa Howard
Susan Cramer