I see now that my question -- Are Open Notes good or bad for Healthy Survivors? -- is the wrong question. Patients already have the legal right to read their charts. Open Notes are here to stay. The questions I should be asking are these:
"How can Healthy Survivors use their medical chart in healing ways? And how can clinicians ensure that Open Notes are healing, and not harmful, to patients?
Today I'll address the patient's question, since it's easier for me.
- Patients who don't want to read their chart can still ask for copies of their test results and physician's notes to keep in a notebook at home as a spare copy. Then, if a result gets lost or a consultation is scheduled, patients can ensure needed records are available.
- After a visit, patients can review the notes. If they read something that conflicts with what they thought they heard, they can call the office and ask for clarification. If necessary, they can make an appointment to clear up the confusion.
- After a visit, patients can use the notes to help them explain things to family and friends.
- After a visit, patients can use the chart to make themselves a list of health-related short-term and longer-term goals.
- Before an upcoming visit, patients can review the notes from the last visit to help prepare their update summary for their physician as well as to prepare their questions and concerns.
I find that there are still office staff that fight you if you wish to see your records, even though the doctor said you could. Once you are at the office window and say you have forgotten a fancy word the doc used and reach for your file to see how it is spelled, you would think you were holding up a bank! Of course by then the doc is with another patient, so you sit until he can be asked. More communication within offices would be nice.
I use my records to be able to research things and ask more informed questions of the doctor so I don't waste his time.
Posted by: Mickey Lewis | August 25, 2010 at 06:05 AM
Dear Mickey,
Your imagery is effective, highlighting one of the obstacles to patients making use of their legal right to see and amend their charts. As you'll see in my upcoming posts, I remain optimistic about things getting better for patients. With hope, Wendy
Posted by: Wendy S. Harpham, M.D. | August 25, 2010 at 06:56 AM