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.
WIHI: End-of-Life Care and How Communities Can Become "Conversation Ready"
WIHI: 10 Things Every Hospital Needs to Know to Be Safe
WIHI: The Road to Team-Based Primary Care and Behavioral Health
WIHI: 100 Million Healthier Lives by 2020
WIHI: Optimizing Safety with the Electronic Health Record: The Latest on Glitches and Fixes from the Frontlines
WIHI: Better Care and Better Value for Hip and Knee Replacement
WIHI: Mental Health Care in the Hospital: Preventing Harm, Promoting Safety
WIHI: From Here to CLER: Graduate Medical Education and the Clinical Learning Environment Review (CLER)
WIHI: Tread Water No More! Making Sense of Patient Experience Data
WIHI: Preventing Financial Harm to Patients: The Costs of Care Initiative
WIHI: From Prehospital to In-Hospital: The Continuum for Time-Sensitive Care
WIHI: New Roles, New Routes for Managing Populations
WIHI: Making the Work of QI Less Draining and More Sustaining
WIHI: The Patient-Centered Medical Home: Early Results, Tough Scrutiny
WIHI: Partnering with Patients for Safety: The Next Phase of Work and Commitment
WIHI: Transforming Tensions and Tempers on Health Care Teams
WIHI: Reclaiming Empathy — Best Practices for Engaging with Patients
WIHI: Bright Spots for Patients with Complex Needs
WIHI: How High? How Low? Shared Decision Making Amidst Shifting (Hypertension) Guidelines
WIHI: Mobilizing Skilled Nursing Facilities to Reduce Avoidable Rehospitalizations
Create your
podcast in
minutes
It is Free
Good Mood Revolution
The Relaxback UK Show
On Call With Dr. Anselm Anyoha
Precision Medicine Forum Podcast
The Doctor’s Farmacy with Mark Hyman, M.D.
The Peter Attia Drive