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  semundjet zemres wrote @ July 9th, 2009 at 6:35 am

At the West Los Angeles VA Healthcare Center there has also been rather open access for patients for at least a few years, although not as open as described in this Boston project. There have been a few patients who have become upset or who have disputed the veracity of the recorded notes, examination, or medical history. A process allows them to either dispute or enter information into their own charts. This openness dovetails well with the VA’s policy of providing full-time patient advocates to assist our patients if they have concerns or complaints. It has been my impression that more often that patients have found this helpful. There are a number of motivated patients who have been active participants in their own healthcare and who have used their own knowledge of the medical records to assist and guide their physicians. I have had a number of patients come to me with questions or comments about the note I had written about their previous visit with me. This has been an opportunity to make sure the patient understands my clinical concerns. Skeptics about this process should note that I have always been open with my patients about my concerns. For instance, if I ordered a test to rule out neoplasm I would share that concern with my patient, but also put it in realistic perspective. If my note describes a patient’s morbid obesity it would most likely be because I had discussed this medical issue with them.

  Fort Myers Plastic Surgeon wrote @ July 10th, 2009 at 11:44 pm

The Chronic Care Model describes the necessary components for a delivery system that encourages and sustains productive interactions between patients and providers. We have to learned that the hard work of clinical practice change requires more than just good intentions and a goal.

Covering topics like selecting and using clinical information systems and working with team members to provide self-management support and guideline-based care, these practice change tools and instruments have proven useful to the teams with whom we’ve worked.

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