Open Notes: Demonstrating and evaluating transparency in primary care (Phase 2)

The OpenNotes project tests the radical yet simple idea that physicians' notes should be for the patient, not just about the patient. This 12-month study has primary care physicians sharing with their patients the notes they record from office visits through a secure electronic medical record. Approximately 100 doctors and 21,000 patients are taking part across the study's three sites: Boston's Beth Israel Deaconess Medical Center, Geisinger Health Systems in Pennsylvania and Harborview Medical Center in Seattle.

This seemingly subtle shift in how we conceptualize doctors' notes repositions patients at the center of the clinical encounter. As the trends toward transparency and more widespread use of electronic and personal health records in health care accelerates, more patients are viewing laboratory results, medication lists and other parts of the medical record online. This project pushes the boundaries of current practice in an effort to dramatically increase patients' involvement with their health and their care providers.

According to Pioneer team member and RWJF Assistant Vice President Steve Downs, making physicians' notes readily available to patients is an "elegant system tweak that could really affect the behavior of clinicians and patients alike." The OpenNotes team will assess whether the intervention effectively breaks down communication barriers among physicians and patients and promotes shared decision-making, making the relationship more open and democratic. Tom Delbanco, the co-principal investigator, says, "What excites me in this adventure is to learn what works and what doesn't work. I think over time it will really transform the way people look at their own health care."

Learn about Open Notes

Grant Details

Amount Awarded $1,397,370.00

Awarded on: 5/7/2009

Time frame: 5/15/2009 - 5/14/2012

Grant Number: 65921


Beth Israel Deaconess Medical Center Inc.

330 Brookline Avenue
Boston, 02215-5491


Thomas L. Delbanco
Project Director


Janice D. Walker
Project Director