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“T” Is for Transparent

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Patient-Centered Primary Care
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Abstract

The relationship of multiply-disadvantaged patients with their health professionals is often characterized by a lack of transparency on both sides. In order to allow the kind of communication that builds trust, increases patient adherence, lowers healthcare costs, and improves the care experience and the health of the patient, increasing transparency is important. Transparency in doctor-patient relationships generally has taken a big step forward with the wide implementation of “OpenNotes,” software that allows patients to read their doctors’ notes about their care. For multiply-disadvantaged patients, i.e., patients for whom trust and adherence have tended to be more difficult, open notes has been particularly effective and appreciated. When notes are available to patients, researchers in the field suggest that doctors should adjust their language a bit to make the notes more engaging. These same adjustments can be used to allow clinical conversations between team members about patients to occur in the presence of the patient, enabling much more meaningful patient participation in their care. The practice of speaking about the patient in the patient’s presence can allow a much more effective transfer of positive relationship with the patient from one team member to other members of the team.

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Notes

  1. 1.

    Hospital systems commonly have a compliance office made up of staff members, some of whom are lawyers, who do internal monitoring of records and practices so that when external reviewers or auditors arrive, the institution will not have to give back payments that are judged to have been inappropriately obtained because the existing documentation doesn’t support them.

  2. 2.

    The ideas about passing the relationship were first published in Blount, A. (2018). It takes a team. S. Gold and L. Green (Eds.) Your Patients are Waiting: Integrating Behavioral Health for the Primary Care Physician. Springer Publishing, New York.

References

  1. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.

    Google Scholar 

  2. Mautner DB, Pang H, Brenner JC, Shea JA, Gross KS, Frasso R, Cannuscio CC. Generating hypotheses about care needs of high utilizers: lessons from patient interviews. Popul Health Manag. 2013;16:S26–33.

    Article  Google Scholar 

  3. Pollack KI, Alexander SC, Grambow SC, Sulsky JA. Oncologist patient-centered communication with patient with advanced cancer: exploring whether race and socioeconomic status matter. Palliat Med. 2010;24:96–8.

    Article  Google Scholar 

  4. Willems S, De Maesschalck S, Deveugele M, Derese A, De Maeseneer J. Socioeconomic status of the patient and doctor-patient communication: does it make a difference? Patient Educ Couns. 2005;56:139–46.

    Article  CAS  Google Scholar 

  5. Shenkin BN, Warner DC. Sounding board: giving the patient his medical record: a proposal to improve the system. N Engl J Med. 1973;289:688–92.

    Article  CAS  Google Scholar 

  6. Tollast O. Transparency and medical records. Salzburg Global Seminar. March 12, 2017. https://www.salzburgglobal.org//calendar/2010-2019/2017/session-553.html

  7. Delbanco T, Berwick DM, Boufford JI, et al. Healthcare in the land called PeoplePower: nothing about me without me. Health Expect. 2001;4:144–50.

    Article  CAS  Google Scholar 

  8. Delbanco T, Walker J, Darer J, et al. Open notes: doctors and patients signing up. Ann Intern Med. 2010;153:121–5.

    Article  Google Scholar 

  9. Walker J, Leveille SG, Ngo L, et al. Inviting patients to read their doctors’ notes: patients and doctors look ahead: patient and physician surveys. Ann Intern Med. 2011;155:811–9.

    Article  Google Scholar 

  10. Delbanco T, Walker J, Bell SK, et al. Inviting patients to read their doctors’ notes: a quasi-experimental study and look ahead. Ann Intern Med. 2012;157:461–70.

    Article  Google Scholar 

  11. Walker J, Meltsner M, Delbanco T. US experience with doctors and patients sharing clinical notes. BMJ. 2015;350:g7785.

    Article  Google Scholar 

  12. Gerard M, Chimowitz H, Fossa A, Bourgeois F, Fernandez L, Bell S. The importance of visit notes on patient portals for engaging less educated or nonwhite patients: survey study. J Med Internet Res. 2018;20:e191.

    Article  Google Scholar 

  13. Rathert C, Porter TH, Mittler JN, Fleig-Palmer M. Seven years after meaningful use: Physicians’ and nurses’ experiences with electronic health records. Health Care Manag Rev. 2017:1–11.

    Google Scholar 

  14. Makoul G, Curry R, Tang P. The use of electronic medical records. J Am Med Inform Assoc. 2001;8:610–5.

    Article  CAS  Google Scholar 

  15. Ratanawongsa N, Barton JL, Schillinger D, et al. Ethnically diverse patients’ perceptions of clinician computer use in a safety-net clinic. J Health Care Poor Underserved. 2013;24:1542–51.

    Article  Google Scholar 

  16. Schutzbank A. V.P. of Iora Health. Personal communication, 29 Sep 2018.

    Google Scholar 

  17. deBronkhart, D. Let patients help. Richard Davies deBronkhart Jr.;2013.

    Google Scholar 

  18. Ventres W, Kooienga S, Vuckovic N, et al. Physicians, patients and the electronic health record: an ethnographic analysis. Ann Fam Med. 2006;4:124–31.

    Article  Google Scholar 

  19. Rollnick S, Miller WR, Butler CC. Motivational interviewing in health care. New York: Guilford Press; 2008.

    Google Scholar 

  20. Gerbert B, Danley DW, Herzig K, Clanon K, Ciccarone D, Gilbert P, Allerton M. Reframing “prevention with positives”: incorporating counseling techniques that improve the health of HIV-positive patients. AIDS Patient Care STDs. 2006;20:19–29.

    Article  Google Scholar 

  21. Stanhope V, Ingoglia C, Schmelter B, Marcus SC. Impact of person-centered planning and collaborative documentation on treatment adherence. Psychiatr Serv. 2013;64:76–9.

    Article  Google Scholar 

  22. Jain N, Okanlawon T, Meisinger K, Feeley TW. Leveraging IPU principles in primary care. NEJM Catalyst. June 27, 2018.

    Google Scholar 

  23. Apostoleris NH, DeGirolamo S, McConarty P, Mazyk B. Overcoming barriers to mental health utilization: examining the referral process in a community health center-based family medicine residency. Presented at the Annual Conference of the Society of Teachers of Family Medicine. 2005.

    Google Scholar 

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Blount, A. (2019). “T” Is for Transparent. In: Patient-Centered Primary Care. Springer, Cham. https://doi.org/10.1007/978-3-030-17645-7_7

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  • DOI: https://doi.org/10.1007/978-3-030-17645-7_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-17644-0

  • Online ISBN: 978-3-030-17645-7

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