WIHI - A Podcast from the Institute for Healthcare Improvement
Health & Fitness:Medicine
Date: November 1, 2012
Featuring:
Some changes in medicine are easier to contemplate than others. For a long time the notion that patients should be able to view what doctors write about them, following a visit, was unthinkable. It was a kind of “patient don’t ask, doctor don’t tell” policy. However, the growth of electronic health records, increased pressure for transparency, and the need to improve communication and understanding between patients and providers in every way possible are all tugging at information once considered off limits.
Despite the fear that “physician notes” have a tendency to be brief, even glib, and might unintentionally insult or alarm the reader, some health systems, like Dartmouth Hitchcock, have been successfully offering patients easier access to these notes, along with the entire electronic health record, for several years. [See the December 2009 WIHI: OpenNotes and the Electronic Medical Record.]
Still many more health systems have been on the fence, waiting for evidence that there’s value in doing so — and that the benefits outweigh the risks. Now that evidence seems to have arrived, and this WIHI digs into the experience of more than 13,000 patients and 100 primary care doctors who were part of a pilot study.
The findings appear in the October 2, 2012, issue of the Annals of Internal Medicine, reporting on a one-year experiment with what have come to be called “open notes” at three major health care organizations: Beth Israel Deaconess Medical Center (BIDMC) in Massachusetts, Geisinger Health System in Pennsylvania, and Harborview Medical Center in the state of Washington.
WIHI host Madge Kaplan welcomes lead author of the study, Dr. Tom Delbanco, one of the key innovators behind OpenNotes and their trial use at BIDMC, and two clinicians who helped lead the pilots at Geisinger and Harborview. By making notes accessible to patients in their own practices, both these clinicians came to better understand shared decision making and the ways in which transparency, rather than offend, increases trust. Michael Meltsner shares what mattered to him when he faced serious illness. A distinguished law professor, Meltsner’s “A Patient’s View of OpenNotes” also appears in Annals, and captures the brave new world of patient expectations and the need to level the playing field.
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WIHI: How to Build Better Behavioral Health in the Emergency Department
WIHI: Addiction Treatment Demystified: Proven, Practical Steps for Complex Care.
WIHI: Strategic Pathways to Population Health
WIHI: Giving Patients and Families the Tools to be Health Care Improvers
WIHI: How to Make Change Happen: An Introduction to IHI's Psychology of Change Framework
WIHI: Pursuing Health Equity in North Carolina
WIHI: Sustaining and Strengthening Safety Huddles
WIHI: Mobility Matters for Age-Friendly Care
WIHI: Mindfulness and Patient Safety
WIHI - Aging in Place with a Disability and Dignity
WIHI: Practicing More Careful and Thoughtful Diagnosis
WIHI: What's in a Name? Health Care's Chief Quality Officer.
WIHI: Opioid Crisis: Changing Habits and Improving Pain Management
WIHI: Discovering Your Way to Greatness
WIHI: The Careful and Kind Patient Revolution
WIHI: Health Care Innovation and R&D - Taking Stock at Ten Years
WIHI: A New Emergency Checklist for Office-Based Surgery
WIHI: QI Takes on Veteran and Chronic Homelessness
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