OpenNotes makes it easy for patients to access electronic medical notes. Doctors record their notes in the patient’s electronic medical record, and after each visit, invite patients by email to view the notes through a secure online portal.

In the OpenNotes project, primary care physicians (PCPs) and their patients in nine practices in three states were invited to participate in a demonstration project and surveyed about potential benefits and risks of open visit notes. While 36 percent of practices declined to participate, half of those completed the survey. Only patients who registered for the patient portal, however, were invited to complete the preliminary survey. See related video at right.

Participating PCPs thought that open notes were a good idea (69% to 81%) and would improve patient satisfaction. Patients overwhelmingly (92% to 97%) saw benefits.

Nonparticipating PCPs thought that visits would be longer and that there would be increased demands on their time between visits. They worried about frightening patients and about candidly recording thoughts on patients’ mental health, substance abuse, cancer and obesity.

Investigators did not find younger and more highly educated patients more enthusiastic than others about open notes. Another important finding: more than half of patients would share notes on their doctor visits with family, friends and other caregivers, giving rise to concerns about privacy.