“Pay no attention to that man behind the curtain!” This was how Dr. CT Lin, CMIO at University of Colorado Hospital & Health Sciences Center, opened his talk at the Healthcare Forum. Dr. Lin’s premise was that we have kept healthcare information hidden from patients for far too long. Giving patients access to their medical record does not create confusion and extra work for providers, but instead there is strong evidence in Dr. Lin’s research that patients are highly engaged and satisfied with access to their record and it does not create added burden on providers.
While the mystique of the all knowing, all powerful doctor is a strong one, healthcare is changing. We’re quickly moving from the all knowing, no mistake doctors, to a more realistic paternal collaboration between doctors and patients. No doubt this change is a hard shift in medical culture. Take a simple look at the 5th century BC Hippocratic Oath [emphasis added]:
“I will impart a knowledge of this art…to pupils who have signed the covenant, and have taken an oath according to the medical law, but no one else.”
In the 70’s we started to see the very first shift away from closed records and medical knowledge when patients were allowed to access their paper records. In the 80’s and 90’s we started to see the first patient portals.
Dr. Lin described the old healthcare mentality as follows:
- Knowledge is power. Respect my studies.
- I am too important for clerical tasks.
- Patients do best when they do what I say.
- There is nothing wrong with the way I work.
Then, he suggested where we are headed in healthcare:
- Collaboration is powerful.
- Communication improves safety.
- Connection fosters participation.
- Change requires a burning platform.
This shift requires us to move from a physician centered healthcare system to a patient centered healthcare system. Is it any wonder why physicians feel threatened? However, Dr. Lin has studied how this shift impacts both doctors and patients and the results are profound.
Dr. Lin discussed these results during his presentation at the Healthcare Forum (embedded below):
His presentation focused on studies he conducted on: online messaging, online release of test results, and online release of doctor notes. In each case, Dr. Lin presents the fears many doctors have of connecting with patients in this manner and also the many doctors who see potential benefits of pulling back the curtain. Some of those fears include: “This is a crazy idea; the phone will ring off the hook” and “Patients will be more anxious.” One doctor only agreed to participate in his study because he thought that Dr. Lin was doing a “rigorous study” and he was certain that the study would validate his fears.
The results from his research consistently showed that the “floodgates” of patient requests didn’t open and where studied there was a dramatic improvement in patient satisfaction. The irony of people’s reaction to the study was that it varied based on the clinic’s perspective. For example, a busy clinic that has more patients than it can handle was happy to reduce the number of patient calls while a slower clinic was not happy with that result. An even more surprising result was doctors who found they were better doctors after the change.
Plus, there were plenty of anecdotal examples of patient benefit that were not captured in the qualitative portion of the study. For example, one patient who had been given access to their physician’s notes reported this experience: “I lost my luggage while traveling. I went to a local doc and said: ‘If you have Internet Explorer, I can show you my chart. Could I have a few days of my meds?” Access to the physician notes changed the entire experience.
Dr. Lin’s research has also been confirmed by a 250 doctor initiative called OpenNotes which came to similar conclusions. When you involve the patient, the world does not come to an end. Patients are happier, more satisfied, more connected, and more empowered. Dr. Lin concluded, “Patient centered information technology is fast moving, often out of focus, but always exciting.”
The Breakaway Group, A Xerox Company, sponsored this coverage of the Healthcare Forum in order to share the messages from the forum with a wider audience. You can view all of the Healthcare Forum videos on The Healthcare Forum website.