My annual physical is this Friday. Since my doctor and I were among the guinea pigs participants in the OpenNotes project, I just got this reminder email:
Message Date/Time: 1/17/2012 10:00:06 AM
Read Date/Time: 1/18/2012 7:19:08 AM
From: OpenNotes, Study
To: deBronkart, Richard Davies
Cc:
Subject: Reminder: Review your doctor’s notes before your next visit!
Dear Patient,
You have a visit scheduled with your doctor soon, and you may find it helpful to review the notes your doctor wrote after your last visit.
The doctor’s notes can be found in the new “Notes” section of PatientSite. To view your notes, …
I did, and my goodness, there’s a bunch of stuff in there that I’d forgotten! (Shortly after my June visit I blogged that I’d looked back at the notes to remember a to-do, without having to call the office. Nice.)
Observations:
- It’s good that I can see it. Otherwise I would have been a less-prepared semi-idiot when I arrived.
- Now I’m hustling to follow up on some issues before we meet. Shoulda been doing this earlier.
- There’s more to patient engagement than just having access to the information.
Patients arriving unprepared might give doctors a sense that patients don’t know what’s going on. (Y’think?) It’s my responsibility to look at the notes and act on them, and honestly I’m not in that habit yet. My bad.
btw, my personal vision is for the shared medical record to be organized as a “shared issue tracker,” with dialog and entries about each item. Right now it’s a sequence of individual visit notes, unstructured, with each topic somewhere in each visit. So collecting the notes for a given topic is manual.
(On a separate note, some people freak out at my “disclosing” that I have a doctor’s appointment – and some people even wonder if it’s a HIPAA violation for me to talk about my own medical record. No, it’s my records, my info; HIPAA regulations affect custodians of my data.)
Thanks so much for sharing! Love the idea of a shared issue tracker.
My End of the Rainbow/Holy Grail:
A Shared Plan that includes patient life goals, preferences, perhaps a ‘personal tweet’ (this is what I want you to know about me), as well as shared problems/issues/plans. Could have parts that are shared with clinical team as read-only, parts that are shared as read/write, and part that aren’t shared at all.
To complement those snippets of data from the EHR about meds and allergies….
Dave,
Great post Dave. I have online medical records and was shocked to see several errors in my medical record. Very important ones. But getting them corrected is not easy. They won’t actually change the record; they only allow you to send a ‘letter of amendment’. They don’t require the MD to amend his own mistakes. When I asked if the insurance company gets a copy of my letter of amendment, I was told that this wasn’t their policy. Another thing we need to add to the empowered patient and patient safety ‘to do’ list.
Happy, Healthy New Year!
Holy crap, Lori! I’ve never seen a more powerful argument for having all the records (including “amendments”) in one place! And it sure makes clear who is motivated to make sure they’re accurate!
With the word-processing technology we now have, there’s no excuse for not having the record directly corrected by use of a review feature similar to Microsoft Word. Changes by the patient would be indicated by a different color typeface, and mousing over that would show the patient’s correction.
Thus, the physician would get what (s)he wants — no actual changing of what (s)he wrote, but an amendment at the “spot of the foul” — not someplace you have to search for it and then find the section it amends.
Be happy you have access to those notes. When I finally (after 5 years) got a copy of my onco paper record I discovered that I suffered from TB sometime in my past. Never knew. When I asked how that got in there they did not have a decent answer. I didn’t even bother to ask for a correction, the “information” had already spread too far to other MDs.