OpenNotes faculty and scholars conduct research and collaborate with investigators around the world to understand the effects of fully transparent medical care on communication, engagement, safety, costs, and the overall quality of care. Below you can review work conducted by OpenNotes faculty and scholars, often joined by colleagues from a wide variety of settings in the US and beyond.
Want to join OpenNotes research efforts?
Send us a message.
Dermatopathologists’ Experience With and Perceptions of Patient Online Access to Pathologic Test Result Reports
In this survey study of 160 dermatopathologists, 57% reported that they have been contacted by patients about their pathologic test result reports.
In the past decade, health institutions in over ten countries—including Australia, Canada, Sweden, and the USA—have begun to provide patients with access to their clinical records via secure online portals. So far, however, few health organisations have chosen to share clinical notes written by mental health professionals. Clinicians, especially those working in psychiatric settings, remain concerned that patients could become anxious, confused, or offended by what they read, and that sharing notes will create an extra work burden for mental health professionals.
Embracing the new age of transparency: mental health patients reading their psychotherapy notes online
Our pilot findings indicate that most patients who read open therapy notes find them valuable for understanding and engaging in their mental health care, with minimal adverse effects.
The international movement pushing to increase transparency by giving patients easy access to their health information parallels a broader shift in healthcare towards increased patient empowerment and participation.
A patient and family reporting system for perceived ambulatory note mistakes: experience at 3 U.S. healthcare centers
Partnering with patients and families to obtain reports on inaccuracies in visit notes may contribute to safer care. Mechanisms to encourage greater use of patient and family reporting systems are needed.
A new study from the OpenNotes project (1) suggests that giving patients access to their physicians’ visit notes may improve their understanding of and comfort with their medications, as well as adherence to medication regimens.
We examined patients’ perceptions of how note reading affects factors related to medication adherence. In addition, we sought to understand their engagement with online medication lists and their willingness to participate in keeping those lists correct and up to date.
OpenNotes After 7 Years: Patient Experiences With Ongoing Access to Their Clinicians’ Outpatient Visit Notes
Following a 2010-2011 pilot intervention in which a limited sample of primary care doctors offered their patients secure Web-based portal access to their office visit notes, the participating sites expanded OpenNotes to nearly all clinicians in primary care, medical, and surgical specialty practices.
Error resulting from missed, delayed, or wrong diagnoses is estimated to occur in 10–15% of ambulatory and inpatient encounters, leading to serious harm in around half of such cases. When it comes to conceptualizing diagnostic error, most research has focused on factors pertaining to: (a) physician cognition and (b) ergonomic or systems factors related to the physician’s working environment. A third factor – the role of patients in diagnostic processes – remains relatively under-investigated. Yet, as a growing number of researchers acknowledge, patients hold unique knowledge about themselves and their healthcare experience, and may be the most underutilized resource for mitigating diagnostic error. This opinion article examines recent findings from patient surveys about sharing visit notes with patients online. Drawing on these survey results, the authors suggest three ways in which sharing visit notes with patients might enhance diagnostic processes: (1) avoid delays and missed diagnoses by enhancing timely follow up of recommended tests, results, and referrals; (2) identify documentation errors that may undermine diagnostic accuracy; and (3) strengthen patient-clinician relationships thereby creating stronger bidirectional diagnostic partnerships. The authors also consider the potential pitfalls or unintended consequences of note transparency, and highlight areas in need of further research.
Impacts of a Web-Based Course on Mental Health Clinicians’ Attitudes and Communication Behaviors Related to Use of OpenNotes
The OpenNotes initiative encourages health care systems to provide patients online access to clinical notes. Some individuals have expressed concerns about use of OpenNotes in mental health care. This study evaluated changes in mental health clinicians’ attitudes and communications with patients after participation in a Web-based course designed to reduce potential for unintended consequences and enhance likelihood of positive outcomes of OpenNotes.