Wednesday, December 7, 2011

Patient Access to Medical Records

I blogged briefly the other day about the new plan to give all NHS patients access to their own medical records online. A few more thoughts:

In the short run, making medical records available to patients will give rise to a great deal of GP/patient friction. Patients won't understand what they read, and will ask for explanation. Some patients will be shocked and offended at the way physicians have characterized them (as frightened, as uncomprehending, as unwilling to discuss certain topics, as obese, and so on). Patients may not understand why a doctor hasn't written down their whole story, or accepted their version of events. A certain number of hours will inevitably be given over to discussion of what patients find in their medical records when they are first made available. (Of course, some of this might be quite healthy--patients, for example, may well discover and correct various errors or omissions in their medical histories.) In the longer run, the availability to patients of medical records will cause doctors to write and to use them differently. Gone will be the comments on patients themselves, and the notes-to-self about options to think about trying. Medical records will become cleaner, clearer, public documents; and at the same time will become a bit less useful for doctors. For that reason, I predict, doctors will come up with other ways--perhaps even extra-legal ways, but in any case ways outside the four corners of the medical record--to note their informal impressions about patients and their families.

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