A half million Cleveland Clinic  patients gained access to more of their healthcare information Thursday – and by the end of the year – they will see all that is in their electronic medical record, including physician notes, via MyChart, the secure online portal.

As Cleveland Clinic officials see it, it’s the right thing to do because it will give patients a more complete picture of their health and empower them to make better, smarter and more economical decisions about their care.

Today patients  can view their after-visit summary, medications list, allergies, immunization records, preventative care details, laboratory results, and radiology reports. If they want to see the rest of their medical records, they must contact the hospital to get hard copies of the EMR.

[See also: More patient engagement proposed for Stage 2 meaningful use.]

The new transparent MyChart EMR will give patients access to pathology records, X-ray reports, physician notes, and the list of their current health issues, which physicians use to briefly describe a patient’s health status, recent concerns, and known diagnoses. Patients will be able to view online nearly everything their doctor sees in their EMR, except for behavioral health information, which is prohibited from release by state law.

“Patients continue to ask for more, and we feel that they need to have more information in their hands to be more engaged in their care, said Lori Posk, MD, medical director for MyChart.”

In Posk’s view, providing patients with this convenient access to all of their medical data will enable them to play a bigger role in their own care and allow them to better collaborate with their care teams.

“Our 21st century, value-based healthcare delivery system requires that patients are actively engaged in their health and healthcare decision-making,” Toby Cosgrove, MD, CEO and president of Cleveland Clinic, said in a statement. “It is our job to provide MyChart-activated patients with the tools and information they need to make informed decisions about their own healthcare, under the guidance and expert advice of their physicians.”

Cleveland Clinic has taken several steps over the years to improve patient access to their medical records. Any patient can gain access to hard copies of their complete medical record, and, earlier this year, the reports associated with medical images including MRI, CT, ultrasounds, and mammograms were made available online through MyChart. The EMR system is expected to be fully transparent to the patient next year.

“We have to approach this change carefully and thoughtfully with the input of all involved in order to be sure that patients receive the appropriate, physician-guided education that will ensure they will fully understand the information they will see,” said  C. Martin Harris, MD, Cleveland Clinic's CIO.  “By enhancing the connection between our patients and their clinicians, we will create new opportunities to use information to more fully engage our patients as active partners in their health and the decisions they make related to the care they receive.”

[See also: Health IT executives share holiday wish lists, hopes for 2013.]

"It is medical information and sometimes it can have dramatic implications for the patient," Harris said. "One of the things that we’ve thought through is the timing for making the information available to the patient is a function of its content. For example, on the pathology result, the last thing we would want to happen is to have a patient find out that they have a new diagnosis of cancer through a computer system."

Beginning this month, Cleveland Clinic will start automatically releasing pathology reports to patients through MyChart.  Patients will have secure online access to both the results and their textual interpretation. There will be a delay built into the release process so that patients will be able to hear the results directly from their physician before logging into MyChart to access them.

The procedure and problem lists and patient notes will be available on MyChart during the next phases of the transparency rollout later this year and into 2014.