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Feature Open health

The US opened up access to health records—how do patients use them?

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2789 (Published 08 December 2021) Cite this as: BMJ 2021;375:n2789
  1. Joanne Silberner, freelance journalist
  1. Seattle, WA
  1. joanne.silberner{at}gmail.com @jsilberner

Since April, the US has required healthcare providers to allow patients full access to their medical records—a milestone in a decades-long effort by a group of researchers and patients. Joanne Silberner examines the impact so far, and whether concerns have been borne out

Many have argued for patients to be given greater access to their medical records. The question is: would patients really use them—and what would they do with them?

That’s what Tom Delbanco and Jan Walker set out to determine 11 years ago. The Harvard Medical School professors invited 14 000 patients in three healthcare systems (Beth Israel Deaconess Medical Center in the Boston area, Geisinger Health System in rural Pennsylvania, and Harborview Medical Center in Seattle) to read the notes their doctors made about their office visits over the course of a year. The patients were not invited to look at their laboratory or pathology results.

Delbanco, Walker, and colleagues reported their first results in 2012: 77-87% of the patients said they felt more in control of their care; 60-78% reported better medication adherence.1 And although 26-36% expressed some privacy concerns, only a handful said they were confused, worried, or offended. Ninety nine per cent wanted open access to continue. Few of the 105 physicians who’d agreed to take part in the test reported longer patient visits or having to spend more time addressing patients’ questions outside the visit. And just 0-21% said it took them more time to write up their notes knowing that patients would be seeing them.

The researchers gathered like minded healthcare providers into a movement called Open Notes, and over the years, they and other researchers have shown that patients with access to their medical records are better prepared for doctors’ visits, and follow doctors’ advice better than those who don’t have …

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