The OpenNotes Project - Why Do We Need It?

In my August 9th post, I introduced you to the OpenNotes project. If you are wondering why we need the study, here is a two-word answer: informational technology (IT).

The advent of IT has changed the face of 21st Century medicine in dramatic ways. Electronic medical records are changing how clinicians record, retrieve and exchange medical information about patients. And online resource centers and support services are changing how patients learn about their disease(s) and treatment(s).

On the legal front, the 1996 passage of the federal Health Insurance Portability and Accountability Act (HIPPA) assured patients the right (1) to review their medical records and (2) request corrections and additions be made to the record. Since then, the medical chart has no longer been the sole purview of clincians. Yet relatively few patients take advantage of their right, either because they don't want to or because they are blocked by obstacles when they do want to.

Great controversy persists on both sides of the stethoscope regarding the consequences -- positive and negative -- for patients.

IT is not going away. We need to understand the potential benefits and risks of open notes. The observational study described in my last post is a start.

In my next post we'll look at some of the concerns of healthcare providers who think open records are not conducive to healing clinicial-patient bonds. 

Comments

[Finn]

I can think of another reason why we need the study: employer-based health insurance. Every time you change jobs or your employer changes insurers, everyone in an HMO or PPO plan has to change doctors. If your complete medical records are not forwarded each time, you start losing your own medical history. After 3 or 4 switches, sizable chunks of your medical history can be missing, even if you tried to have your records forwarded each time. If you can't see them yourself, you have no way of knowing if the forwarded record is complete or merely a summary, which could mean unnecessary repetition of tests, failure to address risk factors, or missed or delayed diagnoses.