Should patients see all personal health information?

A yearlong experiment to give patients unprecedented access to their personal health information is underway at facilities in three states.

Through the OpenNotes project, more than 100 physicians at three facilities — Beth Israel Deaconess Medical Center in Boston; Geisinger Health System in Danville, Pa. and Harborview Medical Center in Seattle — will give 25,000 patients access via secure email to the notes they take during a visit. (Patients have a right to see this personal health information under the Health Insurance Portability and Accountability Act, but red tape often stands in the way.)

The idea is that such access may improve communication and collaboration between patients and physicians, may reduce medical errors as patients and their families more closely monitor care, and ultimately may boost patients’ trust in their physicians, according to project leaders Dr. Tom Delbanco and Jan Walker, both of Beth Israel Deaconess.

There are some potential pitfalls, of course. Physicians may alter notes for candor or complexity before sending them off to patients. In addition, as a discussion on Dr. Bryan Vartabedian’s blog suggests, psychiatrists and other mental health professionals have expressed concern that patients may take notes personally. Finally, many health care providers are concerned that once patients know they can email their physicians, they will do with reckless abandon.

The key question, as a recent Annals of Internal Medicine article points out, is whether patients and providers will see enough value in OpenNotes to continue the project once it officially concludes next summer.

As we’ve reported, patient and vendor interest in personal health records remains tepid at best. Perhaps an initiative embraced by physicians will be more successful. Anything that gives patients better access to personal health information, which they can use to make healthier, more responsible decisions, ought to succeed.

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