The Challenges and Promises of Note Sharing

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Patient seeking more control over medical records are changing the nature of the physician's note, according to a perspective in the New England Journal of Medicine.

The perspective, written by members of the Massachusetts Medical Society and creators of OpenNotes, a Robert Wood Johnson Foundation-funded initiative to examine the effects of open access to physicians' notes, says opening notes to patients will likely change the way physicians communicate clinical information.

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In particular, the article mentions that physicians may become more aware of word choices in communicating diagnoses, especially cancer. Templates may assist physicians with these communications. In addition, some clinicians have expressed concern that having open notes would cause physicians' notes to have "watered down" meaning. Those with this concern suggest setting preferences about what patients are able to view.
From a patient perspective, access to medical information such as physicians' notes helps them better understand their care, stick to treatment regimens and feel in control of their health. However, while access to medical notes may be desirable and convenient, patients are concerned about privacy over sensitive health topics such as mental health and substance abuse.

Despite potential challenges, the authors feel having open notes is a concept that is potentially beneficial across all healthcare settings.

Users of OpenNotes include Boston-based Beth Israel Deaconess Medical Center, Danville, Pa.-based Geisinger Health System, Milwaukee, Wis.-based Columbia St. Mary's and the Department of Veterans Affairs.

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