Inviting Patients to Read Their Doctors' Notes

A Quasi-experimental Study and a Look Ahead

Read the story behind this study in the author interview

This article could help drive a culture of more transparency between patients and providers, empowering two-way communication that levels the proverbial playing field.

In this OpenNotes study, the authors examined the impact on patients and doctors when patients were allowed access to their doctors’ notes via a secure Internet portal. Through the use of surveys, patients’ benefits, concerns, and behaviors, as well as physicians workload, were measured.

Beth Israel Deaconess Medical Center (BIDMC) in Boston, Geisinger Health System (GHS) in Pennsylvania, and Harborview Medical Center (HMC) in Seattle were selected for this quasi-experimental year-long study. The study included 105 physicians and 13,564 of their patients. Patients were notified when their notes were available, but whether or not to open the note was at their own discretion.

The authors analyzed both pre- and post-intervention surveys from the physicians who completed the study; 99 physicians submitted both pre- and post-intervention surveys. Of the patients who viewed at least one note, 41 percent completed post-intervention surveys.

Key Findings:

  • Almost 99 percent of patients at BIDMC, GHS, and HMC wanted to have continued access to their visit notes at the completion of the study; no physician elected to end this practice.

Although a limited geographic area was represented, the positive feedback and clinically relevant benefits demonstrate the potential for a widespread adoption of OpenNotes. Moreover, it is a powerful tool in helping improve the lives of patients.

OpenNotes, a grantee of the Robert Wood Johnson Foundation, was developed to demonstrate and evaluate the impact on both patients and clinicians of fully sharing (through an electronic patient portal) all encounter notes between patients and their primary care providers.


Read a patient editorial and commentary from a doctor working in the Department of Veterans Affairs, also published in the October 2012 issue of the Annals of Internal Medicine.

RWJF Chief Technology and Information Officer Stephen J. Downs discusses final results from the OpenNotes pilot on The Health Care Blog.

The Evidence is in

In the OpenNotes study published in the Annals of Internal Medicine, virtually all patients wanted to continue seeing their doctors’ visit notes, and most said having access to their doctors’ notes would be a significant factor in choosing a new plan or doctor. Despite initial skepticism, no doctors opted to stop sharing their notes with patients when the pilot ended.

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No. 2 Most Influential Research Article of 2012

Read what people are saying about the study...

...In The Wall Street Journal: "Access to doctors' notes aids patients' treatment"

...On CNN's The Chart blog: "Study: Doctors should share notes with you"

...On "Patients like reading their doctors' notes: study"

...On "Patient access to their doctor's notes leads to better care, study finds"

...On The Boston Globe's White Coat Notes blog: "Beth Israel Deaconess study: Letting patients read doctors’ visit notes has positive impact"

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