Open Doctor's Notes

Letting Patients Read the Doctor's Notes by Pauline W. Chen. M.D.  The New York Times.  October 4, 2012.

In 1996, the Health Insurance Portability and Accountability Act (Hippa) has allowed patients to access and amend their own medical records.  In fact, access is controlled by delays, administrative regulations, and permission forms.

For one year, three medical centers allowed and encouraged over 13,000 patients to have complete access to doctor's notes without any restrictions or delay in a study call OpenNotes.  Almost all the patients and a majority of doctors were enthusiastic about the results.  Patients felt more control over their own care, took medications more regularly, and followed their doctor's recommendations.  Doctors experienced none of the expected negative consequences.  None of the doctor's opted to stop sharing their notes with patients after the experiment ended.

The American Medical Association and the American Hospital Association are evaluating more open access to records at more institutions.

Surgeon Speaks on Medical Errors

Article:  How to Stop Hospitals From Killing Us  by Marty Makary.  The Wall Street Journal.  September 21, 2012.

Key Ideas:  Medical mistakes kill enough people each week to fill four jumbo jets.  As often as 40 times a week a surgeon operates on wrong body part.  20-30% of all medications, tests, and procedures are unnecessary.  So states the author, a surgeon at Johns Hopkins Hospital.

To confront this situation the he proposes five reforms  (1)  An informational dashboard including infections, readmission rates, and the volume of the type of surgery performed.  (2)  Anonymous surveys of doctors, nurses, and technicians at hospitals  (3)  Cameras to record procedures  (4)  Doctor's notes that are open to patients.  (5)  Elimination of the increasingly common requirement that patients agree to refrain from saying anything negative about the physician.