In a post this week on the Kevin MD blog, Jon Darer, chief innovation officer for the Division of Clinical Innovation at Geisinger Health System, discussed Geisinger's decision to roll out OpenNotes to most of its physicians and patients.

Geisinger's approach highlights the choices that will be facing many health systems: The results of the OpenNotes study, published last fall, provide compelling evidence to go forward in general, but there is a need to be careful and thoughtful about how to do so. Different specialties and different patient populations have special circumstances that need careful consideration. And each institution has its own culture to be navigated. As more early adopters like Geisinger move forward, we'll learn more about how best to implement this practice and through that learning, make it more widely available. — Steve Downs

“Today, Geisinger Health System, one of the nation’s premier health systems, is taking an important step to expand OpenNotes. We hope other systems follow Geisinger’s lead to share doctors’ notes with patients, giving them information they can use to participate more meaningfully in their care." – Steve Downs

This excerpted post by Geisinger CEO Glenn Steele, MD, first appeared in October 2012, when results from the OpenNotes pilot were released. Geisinger was one of three health systems that participated in the study.

…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.

Earlier this year, the Department of Veterans Affairs (VA) embraced OpenNotes, enabling more than 1 million veterans who currently have access to the VA personal health record to view or download their own medical notes along with their health record information via the My HealtheVet Blue Button. In a recently published study in the Journal of Medical Internet Research (JMIR), the VA's Susan Woods, MD, MPH, a longtime champion of open access and transparency, examined patients’ views and experiences with reading their health records, including clinical notes. The study is the first qualitative look at VA patients’ experiences viewing electronic records that included clinical notes and lab test results. Woods and her colleagues showed that viewing records and notes appeared to empower patients and increase their involvement in their own care but Woods says new communication skills will be needed to optimize the user experience.

In a recent interview, Woods discussed the power of open medical notes for patients and clinicians.   

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.

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.