Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
Click the orange button to the right to learn more about what you can start doing today.
Talk about a light bulb going off over your head… It was as if the heavens opened up and things I had been wondering about for years suddenly make sense to me. So the good news is that I benefited from reading my electronic medical records. The bad news is that I read my file more than 20 years after my original diagnosis of multple myeloma.
My MM diagnosis, treatment history- I was diagnosed with multiple myeloma in early 1994. Local radiation, surgery to my spine, local radiation, induction chemotherapy, an ASCT, remission, relapse, remission, relapse, “there’s nothing more we can do.”
All that between my diagnosis and my final appointment with my oncologist on 9/30/97.
In defense of conventional MM oncology and MM conventional therapies, MM is considered to be an incurable blood cancer with an average life expectancy of 5-7 years and an average five-year survival rate of about 54% according to research.
Reading the medical files of all of that was enlightening, to say the least. Over the past 27 plus years I have learned two things:
Scroll down the page, post a question or comment and I will reply to you ASAP.
“The upside of providing cancer patients with easy access to their physicians’ notes far outweighs any downside, according to a new exploratory study from a major US cancer center that has embraced the “OpenNotes” movement in medicine.
There is growing momentum to provide patients with easy access to their full electronic medical records in “real time,” say the study authors, led by Narek Shaverdian, MD, a radiation oncologist who was a resident at the University of California, Los Angeles (UCLA) during the study.
The Department of Radiation Oncology was one of the first departments at ULCA to adopt OpenNotes, a nonprofit initiative that encourages transparency and provides software that allows an institution’s electronic medical records to be routed to a patient portal.
However, many physicians and institutions have been concerned that, with open access to these notes, “there would be more worry, more confusion, and more problems” for patients, Shaverdian told Medscape Medical News.
But the results from their study largely show the opposite.
“Cancer patients who read their physician’s notes report increased trust in their physicians and better understanding of their treatments, diagnosis, and side effects,” Shaverdian said.
More than 90% of the responsive study participants positively assessed these various measures.
Only small percentages of participants reported increased worry (11%), confusion (6%), and finding information they regretted reading (4%).
However, fewer than half of the study population both read the notes and completed the study’s surveys, indicating that the process did not appeal to everyone.
The study was published online October 17 in Practical Radiation Oncology.
The findings from this study, which was conducted in some 200-plus patients with early-stage cancer, echo some of the results of another OpenNotes study (J Oncol Practice. 2018;14:254-258), although this other study involved patients with advanced cancer…
“We’ve overwhelmingly heard that patients like it,” LeBlanc told Medscape Medical News.
However, he feels some trepidation about open access.
He explained that “working hard to read notes doesn’t automatically translate into meaningful understanding.”
For that reason, “access to notes isn’t the end goal, it’s the beginning of something new and different that we need to figure out together,” he commented.
LeBlanc added that the new study from UCLA adds to a sparse oncology literature: “Most of the research done in this area to date has occurred in noncancer, primary care settings. We’re just starting to learn about what might be different for people with cancer.”
The study led by Shaverdian was based on a two-part survey offered to 220 consecutive cancer patients undergoing radiotherapy at the UCLA Jonsson Cancer Center during 4 months in 2017.
A total of 136 (62%) patients completed the baseline survey; 88 (40%) completed the final survey after treatment.
The pretreatment, baseline survey evaluated initial interest and expectations prior to access to medical notes; the final survey determined usage of the notes and the related impact.
Before seeing notes, the majority of patients believed that open access to oncology notes would improve understanding of diagnosis (99%), treatment side effects (98%), and treatment goals (96%), as well as communication with family (99%).
After accessing notes, patients also overwhelmingly reported an improved understanding of their diagnosis (96%) and treatment side effects (94%), and they felt more reassured about their treatment (96%).
Patient age, sex, or specific cancer diagnoses were not predictive of experiencing the above-noted negative effects from reading the notes, report the authors.
Shaverdian, who is now on the faculty of Memorial Sloan Kettering Cancer Center in New York City, explained that the OpenNotes contain “exactly what we are typing into the EHR [electronic health records] during a clinic visit.”
The notes detail the medical decision making, the related risks and benefits, and the discussion that happened in the clinic.
The notes are a “narrative” that are distinguished from, for example, a radiology report, which is a “raw” document that is mostly limited to brief notations and data about changes in anatomy and thus lack the patient’s wider story, said Shaverdian.
Radiology reports and laboratory results, which are now widely available at major centers and health systems via patient portals, were also initially a source of worry to many clinicians, he said.
Radiation oncologists may be especially motivated to be open about their notes, Shaverdian and colleagues comment.
Patients may have “strong baseline misconceptions” about radiotherapy, they say.
Indeed, at the annual meeting of the American Society for Radiation Oncology in 2017, a survey of breast cancer patients revealed that nearly all (94%) of the women were initially fearful of receiving radiation, and half (47%) had heard or read frightening stories of serious side effects from the treatment.
The most common initial fears related to damage to internal organs (40%), skin burning (24%), and becoming radioactive (7%).
Oncologists and other physicians also have fears — about open access to medical records.
Shaverdian said there is a worry that OpenNotes will “alter what and how physicians write in the notes.”
But that is a red herring, he said. “At the end of the day, these notes are always accessible because medical records are always accessible to patients who request them.”
Shaverdian said that patient privacy is also a concern, owing to potential mistakes or the possibility of records being hacked. Additionally, some people fear that patients will be offended or embarrassed by physician comments. “We didn’t find that to be the case in our study,” he said.
“In cancer, there is a lot of attention given to advances in treatment, imaging, and drugs,” he commented. But this is “an advancement in how we can engage with patients. This can also be a benefit,” he added.”
“Almost 80% of doctors in the United States have switched from paper to electronic health records (EHRs), new government statistics show…”
“”The wrong EHR badly implemented and poorly used by a physician can cause far more harm than effective use of a paper chart. However, the right EHR, well implemented and skillfully used by a physician, is far better than a paper chart,” said Jason M. Mitchell, MD, from the Center for Health IT at the American Academy of Family Physicians, according to the Medical Economicsarticle…”