Open Notes, Open Risk?

The Journal of Medical Internet Research recently outlined a study addressing online patient access to personal medical records (OpenNotes intervention). It is the latest in a series of publications regarding this initiative’s utilization, risks, benefits, and perspectives from physicians as well as from patients. This cohort study surveyed attitudes about privacy in approximately 4000 primary care patients at baseline and 1 year after access to their own medical records via online secure portals. One-third of patients voiced concern about privacy both before and after the study period; however, it did not deter use of the portal, as nearly all participants viewed their records during the study.

What’s the issue?

From the standpoint of a patient, OpenNotes provides timely information gathering and transparency in reporting. From the standpoint of physicians and institutions, the same is true. And in a perfect world, all would be well. Currently, at any office, patients can access their records via telephone, fax, or mail, but OpenNotes creates a ubiquitous and rapid portal. The word portal, however, may breed thoughts of hackers, viruses, and worms to laypeople, and thoughts of lawsuits and bureaucracy to providers. This study did not prove that patients consciously trust the system after 1 year, but perhaps they do subconsciously, as they used the portal anyway. What do your patients think of this evolution in information technology, what do providers think, and where might the glitches, if any, emerge?

We want to know your views! Tell us what you think.