Last week, the New York Times, Washington Post, and Consumer Reports were buzzing about something most Private Practice users have been doing all along…sharing your charts with your clients.
The source of all the excitement are the results of a year long study that surprised even the most seasoned healthcare veterens. The OpenNotes study included 13,564 patients and 105 primary care doctors in three settings, an urban academic medical centre (Boston), a predominantly rural network of doctors (Pennsylvania), and an urban ′safety-net′ hospital (Seattle). Patients were given access to their notes over the Internet and were sent an email when a doctor′s note was posted to their chart. Sound familiar?
Patient’s Response
For patients, the reponse was overwhelmingly positive, with 99% percent of patients wanting to continue with OpenNotes. Patients with access to their charts felt more in control of their care and reported a better understanding of their medical issues, improved recall of their care plan and being more likely to take their medications as prescribed. They also enjoyed being able to login later, having some distance from the exam room, which made it easier to process all of the information from a visit.
Doctor’s Concerns
Prior to the study doctors expressed concerns that sharing their notes would add to their workload. This turned out not to be the case. In fact, not a single doctor elected to stop providing access to notes after the experimental period ended. “As one doctor noted: ‘My fears? Longer notes, more questions and messages from patients … In reality, it was not a big deal.’” In fact, very few patients reported being confused, worried or offended by what they read. The benefits were achieved with far less impact on the work life of doctors and their staffs than anticipated.
Specialties such as maternity care lend themselves particulary well to sharing. People who require multiple visits over many months are far more likely to read their chart than someone with a minor issue requiring a single visit.
A Business Advantage
Another discovery in the study showed that sharing the chart is also good for business, with 89% of patients saying access to notes will influence their choice of providers in the future. In a competitive market this will certainly be adopted quickly as patients demand a more transparent approach to their care.
Our Experience
88% of Private Practice users share their charts with their clients and 57% or those clients are logging in to view their charts. This is particularly exciting when you consider that patient engagement is a major component of the new 2nd stage of meaningful use certification.
Prior to the final ruling, it was proposed that in order to be eligible for the incentive money, 10% of your patients would have to log in and view their chart at least once. Providers and EHR companies quickly claimed this was an impossible task as they couldn’t be held responsible for their patient’s behavior. In the end the final rule only calls for 5% of patients to engage. We are so proud of Private Practice users for exceeding this number by over 10X.
An Exciting Future
During a recent public meeting in Washington D.C. the feeling that this was the start of a major shift was palpable. Sharing the chart was referred to as a “no-brainer” and Kevin Tabb, MD, the CEO of Beth Israel Deaconess Medical Center announced that after participating in the study they will be expanding OpenNotes systemwide. He added that when he polled his department heads the decision was unanimous. Something he’s never seen before.
For more information on OpenNotes, visit myopennotes.org
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