New York Times columnist Pauline Chen, MD, recently wrote about whether patients should have easy access to their medical records. Of course, HIPAA guarantees that all patients have the right to access and amend their medical record; however, this is often easier said than done.

Fundamental questions about the value of sharing medical records with patients remain, Chen writes. “Should medical records be shared as interactive documents between patients and physicians? Can transparency work, or will it end up worrying patients, muddling the patient-doctor relationship and adding more work to an already overburdened primary care work force?”

To help answer these questions, several health centers are taking part in a study that examines the effects of providing access to physician notes to patients.  In the study, patients receive an e-mail sending them to a website to view their physician’s notes after the visit and a reminder prior to a follow-up visit that the notes are available for review. The study has more than 100 participating physicians and 25,000 patients. According to lead investigator of the study Jan Walker, RN, finding physicians to participate in the study has been challenging, while finding patients has been much easier. Walker says that many physicians feel overburdened and are worried about the clarity of their notes.

At Kaiser Permanente where I work, we provide HIPAA compliant electronic access for our patients to access their own results of lab values and tests once they have been screened and reviewed by the ordering physician. Our own electronic record also has an interactive component through “e-secure,” which is an HIPAA compliant confidential email communication portal between the physician and the patient.

Since we’ve put this into place, I’ve noticed a markedly enhanced patient satisfaction in their patient-physician relationship. The emails are limited in words allowed and no attachments can be sent by the patients. My own experience is that patients do not “abuse” this email portal and that my care delivery is actually made substantially more efficient rather than playing “phone tag”. The interactions become part of the medical record documenting the care and advice given.  At the present time, however, the patient is still required to submit written authorization for a hard copy of their own electronic health record at Kaiser Permanente.

What do you think of regularly sharing your notes with your patients? Do you think this would have negative or positive outcomes for your patients or yourself?

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