Technology is advancing how medicine is practiced, giving patients the chance to participate more fully in their healthcare. These new developments have the potential to elevate the provider-patient relationship, and are being welcomed, for the most part, by both groups.
The WebMD/Medscape Digital Technology Survey included 1,102 patients and 1,406 health professionals. Both groups were given an identical set of questions on issues related to technology in healthcare, including using smartphones as part of the diagnostic process and patients’ access to electronic medical records (EMRs) and physician notes. Below are some key findings:
Access to EMRs can improve patient engagement
In the study, while 96% of both physicians and patients agreed that patients should have access to their EMR, 87% of physicians and physician assistants were concerned that giving patients access to EMR data might make them more likely to ask for additional unnecessary tests. Additionally, 89% of patients and 64% of physicians believe that patients should be able to view all of the physician notes in their EMR.
Giving patients access to their physician’s notes is an issue that is under consideration worldwide. Health systems in the U.S. have already done research on this with encouraging results from patients and physicians alike.
A report published in the Feb. 10, 2015, issue of the British Medical Journal, “U.S. Experience with Doctors and Patients Sharing Clinical Notes” discussed the results of the OpenNotes Initiative, a study that involved more than 17,000 patients and 105 physicians at three hospital systems in Massachusetts, Pennsylvania, and Washington. In the study, patients were invited to access their physicians’ notes with their EMRs.
After 12 months, over 60% of patients reported better understanding of their medical conditions, taking better care of their health, and feeling more involved in their care. Among physicians, only 3% spent more time answering patients’ questions, and 11% spent more time writing or editing notes. Ninety-nine percent of patients wanted to continue the use of open notes, and 85% said that having access to notes would influence their decision to use a particular provider or health system in the future.
Giving patients access to their medical information may initially spur them to question their physicians about their condition or about the meaning of their lab results, and this may be more time consuming for physicians. More importantly though, it shows that when given enough information, patients are often enthusiastic about actively engaging in their healthcare, which is a win-win for everyone.
I'll push back on the idea that giving patient access to their EMR data will cause "demanding patient syndrome." That myth was powerfully debunked in the premiere issue of JAMA-Oncology (link to the JAMA editorial, which included study references: http://oncology.jamanetwork.com/article.aspx?articleid=2108844), and the OpenNotes project led by Dr. Tom DelBanco at Beth Israel Deaconess in Boston puts paid to the idea that patients can't participate fully via their clinical team's EMR/EHR tech (report from EHR Intelligence: https://ehrintelligence.com/2015/02/26/opennotes-pilots-show-value-of-patients-annotating-ehrs/).
GIMME. MY. DAMN. DATA. is the rallying cry on the patient side of healthcare transformation, technology division. Go search for tweets with #gmdd in 'em, follow real-time/real-world discussion of this issue from all points of the heathcare system compass.