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Earlier this month I wrote that the OpenNotes project had kicked off. It’s important – if you haven’t read about it, please click that link.

My primary physician and I are participating, but candidly I didn’t expect to get much out of it: as I told a friend, “I’m not sick!”

Yet, the very first time I used it, I noticed something from my visit that I’d already forgotten. And that made me realize I’m not as observant / “adherent” / engaged as I thought.

Here’s what happened.

Shortly after my visit I got a typical PatientSite email “You have a new message on PatientSite.” I logged in and it said my physician’s visit notes were ready to view. So I did. Yeah yeah yeah, interested, I remember that, yeah he said that, gotta remember to follow up on this and that.

A week later I thought “Gotta remember to follow up on … what?” Already it had slipped my mind. So I logged in and looked. Oh: actinic keratosis – “you should have this removed.”

Actinic keratosis (Medline Plus article) is a crusty skin thing. It’s pre-cancerous – usually doesn’t cause trouble but sometimes it does.

I had one removed last October (I blogged about it). And I had a skin cancer removed when I was in my 20s. Worth paying attention to, huh? I knew it, but here’s the thing – when I thought about it in the past, I never knew where to go dig out the notes. This time I just clicked over to PatientSite, and there it was.

Preliminary observation: now that the notes are easily accessible to me (and I know where to look), I *am* looking at them, so I see how much I wasn’t.

And that led to my taking action on an item I’d conveniently (and dangerously) forgotten. Here’s a note I sent today to my primary, Dr. Danny Sands :

—–Original Message—–
From: deBronkart, Richard Davies
Message Date: 6/30/2010 1:35:55 PM
Read Date: 6/30/2010 2:34:16 PM

Looking at my 6/12 visit notes last week, I was reminded that you said I should get the (probable) actinic keratosis removed. I just called and they’re booking in August. Is that okay or should I ask for something sooner?


As I say, the interesting thing to me is that I already  considered myself pretty engaged. On my previous visit, before OpenNotes, I’d had Danny paste the visit notes into an email to me…. which I misplaced and never looked at.

Today I knew where to look – the obvious place. I’m not drawing any conclusions from one anecdote, but that’s a good thing.


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