Look to the Future: Sharing Physician Visit Notes with Patients Improves Engagement and Adherence

More transparency and sharing of information is the way of the future in healthcare. A simple option is to allow patient’s access to their visit notes that physicians keep as a part of their medical record. Patients have a right to see their entire medical record including physician’s notes; however, this doesn’t regularly happen.

Very little is known about the impact on physicians and patients when they are allowed to read physician’s notes from their visits. There are a number of questions including…

1)  Would patients be confused or offended by the information included in physician’s notes?

2)  Would physicians feel they need to spend more time in writing their notes and would they experience increases in the number of questions they receive from patients?

To answer these questions a year-long study was launched to provide patients with electronic access to the physician’s notes from their visits. The study results were recently published on-line in the Annals of Internal Medicine.

Below are the key takeaways from this important study…

* 105 physicians and 13,564 patients participated from three sites in the US

* 11,797 patients (87%) opened at least one physician visit note

*  Of the 11,797 patients that opened at least one note, 5,391 (47%) completed a post-intervention survey

* Of the patients completing post-intervention surveys…
   - 77% to 87% of patients across the three sites reported that open notes helped them feel more in control of their care
   - 60% to 78% of those taking medications reported increased medication adherence
   - 1% to 8% reported that the notes caused confusion, worry, or offense
   - 20% to 42% of patients reported sharing notes with others

* The physicians reported...
   - The volume of electronic messages from patients did not change
   - 0% to 5% from the three study sites had longer patient visits
   - 0% to 8% from the three sites increased time spent addressing patients’ questions outside of visits
   - 3% to 36% changed documentation content
   - 0% to 21% took more time to write visit notes

This study is important because it demonstrates that increased information sharing between physicians and patients increases patient engagement. The impact of this study is…

* A significant number of patients (ie, 60% to 78%) reported increased adherence to medications. Historically, only 43% of patients that start a prescription therapy are continuing that therapy 6 months later.

* The majority of patients (77% to 87%) felt that open notes helped them to feel more in control of their care. This is incredibly meaningful and a key component to empowering patients to take control of their health.

* Overall physicians saw no more than a modest effect on their work lives by sharing their visit notes with patients. This data should help physicians overcome concerns they have in adopting this practice.

 Changes in the healthcare industry are driving the emphasis on decreasing healthcare costs and enhancing patient outcomes. Patient engagement and adherence are critical to achieving these goals, and this study supports open sharing of physician visit notes can have an impact with little additional time investment from physicians.

In the future, the industry must support initiatives that empower patients to take responsibility for managing their health. This is a very personal issue, and what motivates one individual may not work to motivate another. Innovative ideas are needed. Ultimately, many approaches will be combined to form a customized solution that is effective for an individual patient.

At Tunstall AMAC we are focused on helping build and maintain relationships with patients, caregivers, and healthcare providers to drive awareness and knowledge, support patient adherence, and empower patients to take charge of their health. We offer a wide-variety of personal emergency response and telehealth devices that can be used in the home-setting, and we provide 24/7 monitoring and click-to-chat support services to provide support, information, and educational materials to patients, providers, and payers. Our services combined with open sharing of physician’s notes can increase patient empowerment.

We recently published a white paper on how to develop successful patient and caregiver support programs, as well as emerging trends being used to deliver customized and personalized experiences for patients. If you’d like a copy of the white paper titled “Increase Patient Adherence and Do More with Less”, please click to request it.

I’d like to hear your thoughts on the open notes study. Do you think this practice is likely to be widely adopted by physicians? What other innovative solutions do you see for empowering patients to take responsibility for managing their health?

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