Electronic health records generally give a patient online access to lab results, medication history, information on allergies, and some of the doctor’s diagnoses. They usually don’t provide the detailed notes the doctor writes about an office visit, notes that might include the doctor’s observations about a person’s symptoms, behavior, and appearance – for example, if the patient appeared agitated, frail, or confused.
Beginning in January, Beth Israel Deaconess Medical Center in Massachusetts, Geisinger Health in Pennsylvania, and HarborView Medical in Washington state will begin a trial of OpenNotes, a program in which about 30,000 patients will get access to most of the notes their doctors write about them during visits. A hundred primary care physicians have volunteered to participate.
“Legally, patients have the right to see the notes, but we don’t make it easy,” says Jan Walker, project leader at Beth Israel and an instructor of medicine at Harvard Medical School.
Under the OpenNotes pilot, funded by a $1.4 million grant from the Robert Wood Johnson Foundation, participating patients sign in to their healthcare provider’s patient Web portal, which provides secure access to their records and doctors’ notes. The pilot will run one year, and doctors and patients will be surveyed at the end about how it went and whether it should continue.
Doctors’ attitudes about patients seeing their notes tend toward the extremes. “Some say it’s the wave of the future,” Walker says, while others say, “No way José, not interested.” Doctors in the trial can exclude patients they think won’t be able to handle either the technology or information involved. And patients, of course, don’t have to access the notes.
Projects like OpenNotes engage patients in their own care and are likely to improve their health, says Dr. Jonathan Darer, Geisinger’s medical director. Better outcomes are known to occur when patients ask doctors more questions about their care, Darer believes.
The program could be particularly helpful for patients who get nervous during doctor visits and don’t remember everything that was said, Walker says. And for patients in denial about their health problems, she adds, putting the information in writing can be a helpful jolt.
Until I can legally print money at home, or scan my money in for a deposit, then I need one of those banks.
Either that or we alter our monetary system to be 100% electronic, but that's not practical or even possible for a very long time to come due to the digital divide in the US as well as the world.
I also think the old adage of "out of sight, out of mind" has a lot to do with it, banks need to be seen so you know where to put your money, take out a car loan, get a mortgage, or any other number of things.
I know I will never go back to an online company for a mortgage ever again, I spent 8 months in hell trying to buy a home several years ago after going through an online portal for a mortgage. After 7.5 months of that hell I gave up and walked into a branch of a bank, and 2 weeks later was signing the final paperwork on my home.
In terms of the original post, that first paragraphs bothers me when it mentions a concern of the doctors with a patient not being able to handle seeing something like "morbidly obese" in the notes. I would question why that doctor wouldn't have told the patient they were morbidly obese in the first place.
Medical records are long overdue to be made electronically so that they can be accessed by multiple hospitals, doctors, and the patients themselves.
While I am 100% for the digitizing of our medical records, it also needs to be done with caution in order to assure longevity, cross compatibility by making sure that it's not stored in a proprietary format. Yet it also needs to be secure to make sure that no un-authorized access to a patients records occurs, while also allow for the ability of generating a report for the patient about who has accessed their records, when they accessed their records, and under what authority they accessed their records.
Good point, Lawrence. One thing that comes to mind is the ongoing risk of banking online from home -- a risk that seems to put the onus on the customer. Until there's a universally solid way to bank from home, there will always be a place for brick-and-mortal banks.
With all the advantages of electronic banking, why is all the construction in my neighborhood for bank branches? What is there a bank in every supermarket? In fact, the banks are converting former fast food restaurants to branches. Why do half the doors on a Manhattan street open into a bank?
Frankly, with all my opinions, I can not find one that fits this situation
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