Stakeholders Debate Pros, Cons of Clinical Note Sharing Initiatives

June 1, 2015 in News

Interest is growing in programs that allow doctors to share their clinical notes with patients through patient portals, Kaiser Health News reports.

Background

According to KHN, clinical note sharing initiatives began about five years ago through a pilot program called OpenNotes (Luthra, Kaiser Health News, 6/1). The pilot was funded through a $1.4 million grant from the Robert Wood Johnson Foundation Pioneer Portfolio. It involved about 100 primary care physicians and 25,000 patients at:

  • Beth Israel Deaconess Medical Center in Massachusetts;
  • Geisinger Health System in Pennsylvania; and
  • Harborview Medical Center in Washington state (iHealthBeat, 4/10/14).

The program now includes providers at more than 20 organizations throughout the U.S. and an estimated five million patients.

Debate on OpenNotes Continues

Supporters of clinical note sharing argue it could create a fundamental shift in the doctor-patient relationship, allowing patients greater opportunity to catch providers’ mistakes and to have more informed discussions with their doctors.

Some physicians who have participated in clinical note sharing said that patients who take advantage of such access generally:

  • Add more details that could be relevant to their conditions;
  • Are better at following treatment plans; and
  • Correct things such as family histories.

In addition, some patients use the notes to:

  • Challenge a doctor’s recommendation;
  • Help rule out diagnoses by focusing the conversation on key symptoms; and
  • Remind them about their treatment plan.

However, some observers worry that clinical note sharing could cause:

  • Patient confusion if an individual misinterprets the notes;
  • Patients to misunderstand the notes and incorrectly self-diagnose conditions or decline treatments; and
  • Providers to be less honest when writing notes about patients (Kaiser Health News, 6/1).
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