Patients having access to their visit notes is a big step in the right direction, but can co-generating notes – OurNotes — go even further in creating collaboration between patients and clinicians? Our latest pilot intervention addressed this question. We asked patients of participating primary care clinicians in 4 health systems to submit a free text interval history and an agenda for their upcoming primary care appointment. Clinicians were able to view this patient input before and during the visit and to decide whether to integrate the patient’s submissions in the visit note.
Over 12 months, nearly 2,000 patients submitted forms before their visits. More than 90% of the clinicians completing an evaluation survey agreed that having this information ahead of a visit was helpful, and 70% usually or always incorporated patient responses into the visit note. 92% of patients who completed a survey thought being able to send their commentary before visits was a good idea, and 68% felt that answering the questions ahead of time helped them prepare for their visit.
“Overall, both patients and clinicians viewed this intervention as an opportunity to improve care,” says lead author, Jan Walker, MBA, RN, Co-Founder of OpenNotes, Associate Professor of Medicine at Harvard Medical School, and a member of the research faculty in the Division of General Medicine at Beth Israel Deaconess Medical Center in Boston. “They also offered concrete suggestions for enhancing the system. These included providing support/tutorials to help patients with completing the forms, making it easier to find the responses in the record, and streamlining the process for inserting patients’ words into notes.”
As an important indicator of the promise OurNotes holds, each of the 4 sites continued the intervention after the trial ended.