Transparency and behavioral change

I’m exhausted after a long day of discussions and meetings and debate. Emotional, engaging and inspiring.

We started the day with a great presentation of the OpenNotes initative in the US made by Jan Walker. The experience they have made of introducing patients’ online access to the medical records are very similar to what we see in Sweden, both with respect to concerns from healthcare professionals and the positive response from patients. If you are interested in research done on this topic in Sweden, check out the DOME-consortium’s web site where we try to post most of our publications.

This was followed by some excellent presentations on the topic of motivation and behavioural change. The discussion then revolved around the topic of transparency and behavioural change. My reflection on this was that I don’t believe that patients’ access to their medical records will create sudden changes in notoriously difficult areas such as weight loss, smoking cessation, or risky alcohol consumption. The problem here is not that people lack the knowledge or information – and if we just provide them with it they will change. Rather, behavioural change requires a whole different set of tools, and I’m not even sure that healthcare is up to the task to help patients achieve those changes. But that is my personal opinion.

However, that does not mean transparency and patients’ access to their medical record online is not useful – but we have to consider what the goals are! If healthcare professionals expect that this will be an amazing tool for behavioural change, I’m afraid that they will disappointed – and perhaps consider it as a failure. Patients on the other hand, may consider completely different things the main benefits of their access. Patient safety is one of the areas that are obvious to me (I’ve written about that before), but I’ve also written about some of the unexpected uses I’ve found of having access to my record online, which includes remembering names, and knowing what was actually documented during the last visit, so I know what I may have to repeat next time.

For healthcare professionals, this may not seem like the great benefits they were expecting, but I believe it’s a starting point for a more equal and trustworthy relationship between patient and healthcare professional. And last but not least, I believe it is a democratic issue of having the right to access information that will very likely influence your life and health in the future.

[post 10 in the #blogg100 challenge]

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