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Feature Patient Health Records

Access to records: Do open notes work for patients?

BMJ 2023; 381 doi: (Published 13 April 2023) Cite this as: BMJ 2023;381:p789
  1. Joanne Silberner, freelance journalist
  1. Bainbridge Island, WA, USA
  1. @jsilberner

Since 2021, Americans have been guaranteed full and immediate access to their own health records. Joanne Silberner asks if this has helped or hindered treatment

Some 15 years ago, a 67 year old New York City musician had a blood test as part of a routine check up. A few days later he was in intensive care.

His physician had gone on vacation before sharing the test results. Because she was away, no one reviewed the results, his condition worsened, and he wound up being admitted to hospital.

Fast forward to March 2023. The same patient—with a strong family history of early heart disease—had a scan to check his coronary arteries and booked an appointment for the next week. But over the weekend he got an email saying that while most of his arteries were normal for his age, one showed “severe stenosis due to predominantly non-calcific plaque.” The finding left him “stressed and beyond concerned,” he tells The BMJ.

The man’s story illustrates the double edged sword that is patient access to results.

Since April 2021, US medical practices and hospital systems have been required to provide free and immediate access to laboratory reports, exam notes, biopsy reports, and imaging details directly to patients, as a result of the 21st Century Cures …

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