Should Patients Have Full Access to Their Medical Records?

When Beth Israel Deaconess Medical Center announced that it will initiate a project called "Open Notes," dozens of people posted responses on the Boston Globe site. In this project funded by the Robert Wood Johnson Foundation, 100 physicians at the hospital and two other sites will allow 25,000-35,000 patients to read their online physicians' notes for a year. The researchers will examine patients' responses of having full access to what physicians write and determine if access to the notes improves care and outcomes. The thinking is that patients will become more informed and feel more involved in their care. As some people wrote in their posts in response to this announcement, having access may be a good thing since few patients remember the full details of what physicians say, recommend, or prescribe during patient-physician encounters.

Interestingly, many people posting comments were surprised that they did not already have full access to their medical records. As one person wrote, "Isn't there the Freedom of Information Act that lets me see my records?" Another asked, "What are they hiding? Shouldn't it be a no brainer that we can see our records?"

Another person responded by saying that patients’ medical records are in fact available to patients; however, they are available for a fee and generally take days to weeks to obtain after being requested.

Some physicians understandably are concerned that there may unintended consequences of patients having full access to their records. For instance, will physicians need to write in lay-terms so that patients can now understand what they write? Will they need to start writing details that they previously did not need to include when only other healthcare providers had access to the notes? And lastly, is access an open invitation for litigation?

This project will surely receive additional media coverage once it is officially underway. It will be interesting to see how patients and physicians feel about open access to physicians' notes. And most importantly, it will be interesting to see if patients' access will improve outcomes of care.