Health IT, Patient Engagement

OpenNotes advances from research project to ‘movement’

The initial success of the OpenNotes program is well-documented. As MedCity News reported, a study published […]

The initial success of the OpenNotes program is well-documented.

As MedCity News reported, a study published in the New England Journal of Medicine at the beginning of 2014 found widespread enthusiasm about the idea of opening unedited primary care clinician notes to patients at three test sites. After the first year of OpenNotes, 99 percent of the participating patients surveyed said they wanted access to continue, while 85 percent  said the ability to view physician notes would affect their choice of healthcare provider in the future.

Remarkably, not one of the initial 100 primary care physicians in OpenNotes dropped out after the year, despite initial concerns about patients not understanding their documentation or about being overwhelmed by patient questions.

Since the pilot study ended in 2013, OpenNotes has grown to include nearly 5 million patients, Janice Walker, a researcher at Beth Israel Deaconess Medical Center in Boston, who led the study, said Sunday in Chicago. Walker spoke at a HIMSS15 preconference symposium on patient engagement. And participants open their notes nearly 60 percent of the time.

“It’s not just a one-time thing,” said Walker, a registered nurse. “This started out as a research project, and now we think of it as a movement.”

Patients do not want the information dumbed down, according to Walker. “I’m here to tell you patients would rather read the original notes than a summary,” Walker said during the midmorning session. Reading the whole note helps them recall details of the visit and understand the clinical rationale for their physicians’ or nurses’ decisions, according to Walker.

Patients serve as “an extra pair of eyes,” said Dr. Susan Woods, director of patient experience at the Veterans Affairs Medical Center in Portland, Maine, and a proponent of the Blue Button method of providing patients with their medical records. Woods said it is incorrect to assume that notes as clinicians enter them are always accurate.

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