I recently came across a fascinating article that really opened my eyes to the power of transparency. In a study published in the Journal of the American Medical Association (JAMA) in 2012 (http://archinte.jamanetwork.com/article.aspx?articleid=1203517) investigators allowed patients full access to their complete medical record via an electronic health record (EHR). This wasn’t just appointment dates and vaccination data, either. They gave them the whole record: notes, labwork, images, etc.. They hypothesized that providing this increased level of transparency would improve patient safety and lower malpractice claims. What they found was striking: the rate of malpractice claims when this transparency was provided was 80% lower than when record access was not provided. They also noted that more complete record access has the potential to improve patient safety.
For those of us who advocate for increased medical record access in veterinary medicine, this finding isn’t all that surprising. We live in a world where information is everywhere. Especially in veterinary medicine, which is still largely “fee for service”, many clients (especially Millennials) wonder why they don’t have easier access to their pets’ medical records. They see things like:
-invitations from their own doctors to access their health records
-Kaiser Permanente and the US military have been doing this for over 10 years.
-there is no HIPAA in veterinary medicine (though there are state practice acts that govern record sharing)
-there are minimal 3rd party insurance requirements like there are in human medicine.
-the internet has enabled a level of communication that is simply incredible.
So, the thought goes, “If I can have a real-time, video chat with a friend in Australia, why can’t I see my dog’s X-Rays online? I paid for them and I know the technology is available....” Many even rightly ask why they can’t get it on their smartphone. It’s a good question.
There are some providers who make limited parts of a medical record available to clients but these are a very thin sliver of the whole record. As an ER veterinarian, if you bring your cat to me at 9pm on a Saturday, I don’t really care when her distemper vaccine is due; I want to see her full medical record. Has she had any recent bloodwork? What about digital images or patient alerts? Did you hear a heart murmur in your last exam? Did you give her a dose of corticosteroids yesterday? The clients rarely remember and, even if they did, they don’t know the drug or dose. Those details matter. It’s valuable or you wouldn’t have done it in the first place, right?
Some worry that allowing clients to access their records will lead to more phone calls, clients “reading over their shoulder” or second-guessing them. Our experience has been that, while there are definitely clients who will do this, they are extremely rare. The opposite is actually far more common: clients appreciate the collaboration and have newfound value for all that you do for your patients, especially after hours. “Wow….she got a quick ultrasound at 3am?” or “The doctor noticed that she was uncomfortable and did something about it immediately….very cool.” The benefits far outweigh the costs, especially for general practitioners who understand that their office is closed >50% of the time.
During nights and weekends, what good is all that valuable patient information if it’s locked away behind your walls? You didn’t do all those diagnostics for yourself….you did them for your patients' benefit. If it’s worth doing, it’s worth sharing. It’s a new way of thinking, but the time has come.Click to edit your new post...