Monday, September 21, 2009

Transparency With Patient Data

I was disturbed to see some of the comments in the recent story on NPR "Doctors Don't Agree on Letting Patients See Notes." The idea that patients should not ordinarily be allowed to see their own chart notes is anathema to me. When Dr Thane says "We may not as accurately describe the mood of the patient, the tenor of the encounter, for fear that we may get someone perhaps already a little angry during the encounter — more so after they log on and read the note that I just finished," betrays a possible unprofessional documentation in the note. Certainly any provider had better be prepared for the chart to be read by the patient, unless there is compelling legal reason not to allow it (such as mental incapacity etc.)

We have for many years allowed patients to not only read their chart, but make their own notes as well. This is core to the Planetree patient-centered philosophy of care.

"The Planetree philosophy stresses that one of the most valuable learning resources available was the patient’s own medical chart. Patients were encouraged to read their charts daily, ask questions and discuss findings, and participate in the decisions affecting their care. Patients were also encouraged to keep written records of their experiences and observations in Patient Progress Notes, which became a permanent part of their medical chart if they so desired."
by Susan Frampton, Ph.D. and Patrick Charmel

I am glad to know that this idea is finally gaining traction and hope that those who are afraid of this philosophy will rethink their position. I can assure Dr. Tom Delbanco, of Harvard Medical School, that once you open some daylight into patient's charts there is no going back.

Remember when Elaine needed to see her chart on Seinfeld: