Transparency of care

Patrick1 is to be applauded for her enlightening editorial on electronic medical records (EMRs). She wonders, “is sharing the entirety of the electronic medical record with a patient not the obvious next step in the laudable movement toward shared decision-making and patient–physician collaboration?”1

I could not agree more. Like Patrick, I am a newcomer to Canada. In Israel (where I come from), EMRs have been used for over 15 years with enormous success. Access to EMRs is an integral part of patient rights and is available at the click of a button. Lab results are shared and accessible to patients within minutes of being reported. As Patrick points out, with judicious application of appropriate security measures, like those employed to protect banking, pension, tax and insurance information, there should be more advantages than disadvantages to the open access of medical information.1

I would like to expand on Patrick’s editorial1 and suggest that transparency and sharing also extend to the clinic visit summary letter. I am a consultant pediatrician, and in my practice in Israel, I used the EMR to print two copies of my visit summary notes/letter. These were given to the parent or guardian to take with them, one copy to keep for their records and one for their family physician or pediatrician. I have recently started following this practice in Canada. My patients feel so much more empowered and involved in the clinical decision-making process. They leave the appointment armed with a summary of the visit and are able to review the information immediately or later at their convenience. These patients are now questioning why other health care providers do not offer the same open access to their patients’ medical records.

The benefits for me are that I have no more dictations to complete after clinic, I do not have to wait for a transcriptionist to type my letters, and there is no editing required. The consult letter is delivered directly to the referring physician via the returning patient. As a precaution, I do currently send a copy by mail to the family doctor/pediatrician. However, I suspect that as time goes by, this will become unnecessary.

I believe that patients will increasingly demand such transparency from other clinical encounters as well. It is indeed time to embrace transparency!