Lott, Jason, et al., JAMA Dermatology, May 2015
More than 4 decades have passed since the call for “giving patients their medical records” was first proposed to increase patient engagement in health care delivery.1 Today, this vision—once considered radical—is quickly becoming reality, with millions of Americans routinely accessing their medical records through web-based patient portals.1
The electronic health record content that patients can access online is expanding to include physicians’ documentation of patient visits. Recent studies evaluating OpenNotes, a patient-centered initiative enabling online access to providers’ clinical notes, have demonstrated high levels of patient utilization and improved self-reported understanding of care planning and medication adherence, resulting in patients “feeling more in control of their health care.”1 One year after implementation of OpenNotes in 3 diverse health care environments in 2010 (Beth Israel Deaconess Medical Center in Boston, Massachusetts; Geisinger Health System in northeastern and central Pennsylvania; and Harborview Medical Center in Seattle, Washington), more than 99% of patients wished to have ongoing online access to clinicians’ notes, paralleled by similar rates of primary care provider satisfaction.1 Open-access notes have since become standard of care at several large health care systems,2 including the Veterans Health Administration; as of January 2014, more than 1.4 million veterans have registered for full online access to their clinical notes.3
However, medical specialties may face distinct challenges consequent to adoption of open-access medical records. As more patients seek—and demand—comprehensive online availability of open-access notes, what will this mean for the field of dermatology? We believe the following issues merit particular attention among dermatologists in the era of medical record transparency.
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