As the OpenNotes movement spreads, it offers important opportunities to learn from many health care professionals and health systems, as well as millions of patients. We’re collaborating closely with researchers across the country and around the world to understand the effects of fully transparent medical care on communication, engagement, safety, costs, and the overall quality of care.
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OpenNotes and shared decision making: a growing practice in clinical transparency and how it can support patient-centered care
Prior studies suggest inviting patients to read their visit notes (OpenNotes) has important benefits for patient engagement. We utilized survey data to investigate our hypothesis that patients who read more notes would report greater shared decision making (SDM).
The Importance of Visit Notes on Patient Portals for Engaging Less Educated or Nonwhite Patients: Survey Study.
Background: OpenNotes, a national initiative to share clinicians’ visit notes with patients, can improve patient engagement, but effects on vulnerable populations are not known very well.
Objective: Our aim is to examine the importance of visit notes to nonwhite and less educated patients.
Who Reads Their Doctor’s Notes? Examining the Association between Preconceptions and Accessing Online Clinical Notes
Patients who use online portals to review their clinicians’ notes may become more actively involved in their healthcare, but the healthcare industry knows little about factors that may facilitate or inhibit patients’ use of this new practice.
Abstract: There are concerns regarding whether patients with mental illness should be provided with access to their electronic medical records. This study compared perceptions of patients with (n = 400) and without (n = 2,134) a mental health diagnosis regarding access to primary care clinic notes through secure online portals. Eligible participants viewed at least…
Tackling Ambulatory Safety Risks Through Patient Engagement: What 10,000 Patients and Families Say About Safety-Related Knowledge, Behaviors, and Attitudes After Reading Visit Notes
Background: Ambulatory safety risks including delayed diagnoses or missed abnormal test results are difficult for clinicians to see, because they often occur in the space between visits. Experts advocate greater patient engagement to improve safety, but strategies are limited. Patient access to clinical notes (“OpenNotes”) may help close the safety gap between visits. Methods: We…
Sharing clinic notes online with patients and parents may yield many potential benefits to patients and providers alike, but the unprecedented transparency and accessibility to notes afforded by patient portals has also raised a number of unique ethical and legal concerns. As the movement toward transparent notes (OpenNotes) grows, clinicians and health care organizations caring…
Patients frequently depend on informal caregivers (e.g., family, friends, or paid workers) to assist with various aspects of medical care, such as medication administration and travel to medical appointments. OpenNotes seeks to share clinicians’ notes with patients through patient portals. Although patients frequently grant portal access to caregivers, the impact of this improved access to…
The 21st century has ushered in a distinct emphasis on patient-centered care in allopathic medicine, as manifested by the increasing implementation of patient-centered medical homes and the frequent use of patient-centeredness in guidelines, health systems, and insurance language (1–5). The overall goal of this movement is to improve communication between physicians and patients, ultimately increasing patients’ engagement in care and improving the shared decision-making process, and thereby increasing their proclivity to follow their physicians’ advice. The costs attributed to nonadherence are staggering, estimated at $290 billion for medication nonadherence alone (6). Efforts to improve this situation are clearly warranted.
Mafi and colleagues (7) report…
Background: In a rapidly expanding practice directed toward improved communication, patient engagement, and patient safety, clinicians are increasingly inviting patients to read office visit notes on secure electronic portals. Reports from doctors and patients participating in a pilot study are strongly positive (1). However, although patient-reported outcomes indicate that reading notes is valuable, it is primarily a passive activity. As a next step, inviting patients and their families to contribute to their notes may further patient engagement and offload work from beleaguered doctors.
Objective: To solicit ideas from experts about the concept of OurNotes, an intervention in which patients and families co-produce medical notes with clinicians.
What patients value about reading visit notes: a qualitative inquiry of patient experiences with their health information
Background: Patients are increasingly asking for their health data. Yet, little is known about what motivates patients to engage with the electronic health record (EHR). Furthermore, quality-focused mechanisms for patients to comment about their records are lacking.
Objective: We aimed to learn more about patient experiences with reading and providing feedback on their visit notes.
Methods: We developed a patient feedback tool linked to OpenNotes as part of a pilot quality improvement initiative focused on patient engagement. Patients who had appointments with members of 2 primary care teams piloting the program between August 2014-2015 were eligible to participate. We asked patients what they liked about reading notes and about using a feedback tool and analyzed all patient reports submitted during the pilot period. Two researchers coded the qualitative responses (κ=.74).