We might not like everything we read, but a new trial found that giving patients easier access to our exam notes gets us more involved in effective care.
Let's say you gained a bit of weight since your last physical. You know it, deep down at least, but you don't really want to talk about. You've convinced yourself that it's just a phase.
It's one thing to have your doctor point it out to you in the exam room. But what if, at home later that night, you open your computer and see it written right there on your chart: "Patient is approaching an unhealthy weight." What if the doctor used the loaded (if medically accurate) word "obese"?
Before granting open access to their medical notes online through OpenNotes, many doctors expressed concern over this very possibility. Sure, it's their job to make sure their observations about their patients' health are known, but they understandably don't want to come off as offensive. Once they knew patients would be able to peek at what they were writing, some switched over to the more neutral phrase "body mass index."
A year-long, "quasi-experimental" study led by researchers at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston carefully tracked doctors' and patients' experiences with OpenNotes at three sites: BIDMC, Geisinger Health System in Pennsylvania, and Harborview Medical Center in Washington. The results, which were published in Annals of Internal Medicine, indicate that yes, some doctors ended up censoring their opinions, to some degree, out of consideration for their patients' feelings. But they show how open access to the doctor's charts can change the clinical experience, and pointed to ways in which the digital world can be utilized to benefit the doctor-patient relationship.