FARGO — Some health concerns are simply uncomfortable to discuss, even with a doctor.

That’s a situation that Dr. David Newman often confronts as an endocrinologist, a specialist in glandular function.

But there is an alternative to raising a concern in a face-to-face clinic visit.

“A lot of times patients are more comfortable writing things down and having me bringing it up,” he said.

Dr. David Newman, Sanford Health endocrinologist. Special to The Forum
Dr. David Newman, Sanford Health endocrinologist. Special to The Forum

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Sanford Health’s My Sanford Chart now has the capability for patients to raise sensitive concerns in writing using a feature called Our Notes, making it easier to raise awkward concerns such as erectile dysfunction or low sex drive, Newman said.

The recently added option already has been used by 40,000 patients. “We have every specialty doing it,” Newman said.

Electronic notes also are a helpful means of communication with adolescent patients, said Dr. Sarah Manney, a pediatrician and chief medical information officer at Essentia Health.

“As a pediatrician, it works really well,” she said. “It’s quite common, especially for teenagers and adolescents” to be shy about raising sensitive issues.

“Being able to offer another option is just wonderful,” Manney said.

Dr. Sarah Manney, pediatrician and chief medical information officer with Essentia Health. Special to The Forum
Dr. Sarah Manney, pediatrician and chief medical information officer with Essentia Health. Special to The Forum

The option of using patient notes is part of a broader shift to giving patients a greater voice in mapping their care in partnership with their physician, Newman and Manney agree.

“We want to transition to shared decision-making,” Newman said. Patients really like to be heard and to start with their agenda,” Newman said.

Another step in that progression is the move to open notes, he said, which means patients have access to their providers’ notes.

Also, Manney said, “The patient owns their health record.” Opening access to doctors' notes, she added, “absolutely puts the patient in the driver’s seat.”

Opening patient notes can serve as a guide, reminding patients of follow-up steps, she said, adding, “That’s also very useful for families.”

The moves mark a dramatic departure from the old way of practicing medicine, when doctors simply told patients what they thought was best.

“We took a paternalistic attitude,” Newman said. “We ordered the labs, we did what we thought was best,” without including the patient in the decision-making.

“It hasn’t been a rapid shift, but it’s been a steady shift over the years,” he said.

Patients also are often more comfortable raising mental health concerns using the written patient notes.

The notes also are a convenient way to list multiple topics for discussion, making it less likely that something might get overlooked during a clinic visit, Newman said.

The written notes, submitted before an appointment, give providers more time to prepare for a visit.

“I love it because it gives me time to think things through,” Manney said. There was an “old-fashioned” corollary, she added, when patients would sometimes drop off a note. “We’ve actually been doing this for some time.”

Still, electronic medical records, as well as patient portals available online and via smartphone apps, make the information more readily available and communications with providers more convenient for patients, she said.

Just over half of Essentia’s patients are signed up for the electronic medical records portal, MyChart, an indication of the option’s popularity and patient acceptance, Manney said.