By Jan Walker, RN, MBA, and Suzanne Leveille, RN, PhD, of OpenNotes

This is cross-posted from ADVANCE Perspective: Nurses

 As nurses, we've always been focused on the patient. Teaching patients about their health and advocating for patients are both incredibly important parts of the job. That's why we got involved with OpenNotes-an initiative that invites patients to review the visit notes written by their doctors, nurses, or other clinicians.

Health care is one of life’s most basic needs. It’s so simple. In recent years, though, the subject of health care has also served to polarize our nation. We all need it, but who’s responsible for making sure we get it? How do we ensure it’s safe, high-quality care? What about cost? Vocal, contentious debate over the answers to these questions—and many more—continues unabated in the United States. Meanwhile, in my work as a volunteer nurse at a clinic for the uninsured, I see patients who continue to lack the means to get even the most basic of care, who struggle with chronic disease in a system that seems to throw up obstacles at every turn.

That’s the bad news.

Here’s the good news: Amidst the unproductive noise, countless innovators from all walks of life are quietly going about the work of solving some of the most intractable problems in health and health care. 

Antibiotics are a shared resource for protecting the public’s health. Since their introduction in 1941, antibiotics have saved millions of lives and transformed modern medicine. But the more you or I—or anyone—uses antibiotics when we don’t need them, the more we contribute to the development of antibiotic-resistant microbes—and to the frightening prospect of a world where most infections don’t respond to antibiotics. If we don’t take collective action soon, this unthinkable scenario could become a reality.

To many who have heard these warnings before, antibiotic resistance seems like an evergreen issue that is always off in the distance. That is simply no longer true. We lose more people to just one kind of drug-resistant infection—methicillin-resistant Staphylococcus aureus—than to HIV. The cumulative toll from all resistant infections in the United States is much greater. Each and every one of us has a responsibility to protect the arsenal that we have—those antibiotics that are still effective—to fight deadly pathogens.

This blog entry was originally posted to the Association of American Medical College's AAMC Reporter blog.

Academic medical centers are, by definition, hubs for education, research, and patient care. They are essential to creating a health care system in which new knowledge is translated into practice for real-time treatment and quality improvement.

Academic medical centers should be centers of lifelong medical learning and knowledge sharing, where medical professionals expand their expertise and competencies throughout their careers and where best practices are disseminated to the field. They can serve as forums for ongoing mentoring and case-based training. They can host expanded practice communities, where professionals from multiple disciplines, specialties, and even locales work together to provide better care to more people.

By Glenn D. Steele Jr., MD, CEO of Geisinger Health System

A group of health leaders, consumer advocates, and medical professionals are gathering in Washington, D.C., today to advance a simple idea that I see as transformational—having doctors make medical notes available to their patients so they can become more engaged in their care. As a health system CEO who also is a doctor, I believe it is an ethical imperative that our patients at Geisinger know everything that we know about them. And, I think it’s a logical imperative that if we can open up our medical visit notes to our patients, we’ll find out what they understand and what they don’t, so we can answer questions and work as partners to chart a path to better health.

The idea of open medical notes is not just an interesting theory. Geisinger just participated in a year-long study called OpenNotes with Beth Israel Deaconess Medical Center in Boston and Harborview Medical Center in Seattle in which more than 100 primary care doctors invited more than 13,000 patients to see their doctors’ notes. The evidence, published last week in the Annals of Internal Medicine, makes clear that open notes is something patients want, something they use, and something that doesn’t unduly burden doctors. In fact, it also is something that could lead to better care and potentially could save health care dollars—as many as 70 percent of patients said that having access to their own visit notes prompted them to adhere to the medications their doctors prescribed.