Enabling patients to see their doctors' visit notes is a simple idea that has the potential to transform the way patients engage with their health care. OpenNotes helps us move toward an era when patients have the information they need to become true partners in discussions and decisions about their care.
Supported by the Pioneer Portfolio, researchers undertook a year-long trial of OpenNotes in which 105 doctors shared their notes with more than 19,000 patients in Boston, rural Pennsylvania, and Seattle. They found that when patients have access to their doctors’ notes, they feel more in control of their health care, better understand their medical issues, and report they are more likely to take their medications as prescribed. Virtually all participants supported the idea of seeing their medical notes, and no doctors elected to stop sharing visit notes with their patients once the study ended.
With this evidence in hand, OpenNotes is working to make sharing visit notes with patients a routine part of care. The Department of Veterans Affairs has adopted OpenNotes, and more than 500 doctors at Geisinger Health System are now sharing notes with their patients. Expansion plans are under way at other health systems across the country.
Beth Israel Deaconess Medical Center Inc.
Tom Delbanco, MD
Janice D. Walker, RN, MBA
A “New Medicine” With Clear Benefits
OpenNotes set out to answer a simple, but revolutionary, question: What happens when we give patients access to the notes their doctors write about them? The answer: Patients become more active partners in their health care.
Health Care Leaders Speak Out
Hear health care leaders talk about OpenNotes and how it has transformed patient care at their facilities.
OpenNotes was tested in three health centers around the country: Beth Israel Deaconess Medical Center, a teaching hospital in Boston; Geisinger Health System, a rural set of clinics in Danville, Pa.; and Harborview Medical Center, a safety net hospital in Seattle.
After 12 months of note-sharing, doctors and patients reported on their experiences. Having easy access to their doctors’ notes helped patients feel more in control of their care. Patients also reported a better understanding of their medical issues, improved recall of their care plan, and being more likely to take their medications as prescribed.
Doctors who participated in the study reported that most of their fears about sharing their notes with patients—greater demands on their workload and confusing or worrying patients—did not materialize. Many reported that note-sharing strengthened their relationships with patients by enhancing trust and transparency, improving communication, and increasing shared decision-making.
News and published research from OpenNotes
This article relays the experience of Leonor Fernandez, MD, with OpenNotes. Through the story of his patient Diana, among others, Fernandez reflects on the complexity of the patient-provider relationship and the ways in which sharing patient notes provides both opportunities and challenges.Read more
In this study, the authors conducted a one-year, multi-site trial of patient-accessible online office visit notes system OpenNotes, and found that many primary care physicians were willing to participate.Read more
In a study in the Annals of Internal Medicine, primary care physicians and their patients in nine practices and three states were invited to participate in an OpenNotes demonstration project and be surveyed about potential benefits and risks of open visit notes. Participating primary care physicians and their patients thought open notes were a good idea and would improve patient satisfaction.Read more
This article in the Annals of Internal Medicine, published July 20, 2010, reports on conversations the authors conducted with doctors and patients about anticipated risks and benefits of open medical record access before they experienced OpenNotes. Benefits anticipated by patients and doctors included better communication with one another, improved recall of the patient visit, and increased ability to build a personal care network with family and friends.
RWJF Program Areas
REad what People are saying about Opennotes...
...In HealthLeaders Media: "Opening Up to Patients"
... In AHRQ’s Health Care Innovations Exchange: "Online Patient Access to Visit Notes Generates Positive Early Reviews From Patients and Primary Care Physicians"
...In The New York Times Well blog: "Letting Patients Read the Doctor’s Notes"
...In The Wall Street Journal: "Access to Doctors' Notes Aids Patients' Treatment"
...On Forbes.com: "Historic Day in Opening Doctor's Notes"
...In The Atlantic: "Would You Want to See Everything Your Doctor Writes About You?"
...On CNN's The Chart blog: "Study: Doctors should share notes with you"
...In Reuters: "Patients like reading their doctors' notes: study"
...In Kaiser Health News: "For Patients, What A Difference A Note Makes"
...On ConsumerReports.com: "Patient access to their doctor's notes leads to better care, study finds"
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