Few patients read their doctors’ notes, despite having the legal right to do so. As information technology makes medical records more accessible and society calls for greater transparency, patients’ interest in reading their doctors’ notes may increase. Inviting patients to review these notes could improve understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes. Yet, easy access to doctors’ notes could have negative consequences, such as confusing or worrying patients and complicating rather than improving patient–doctor communication. To gain evidence about the feasibility, benefits, and harms of providing patients ready access to electronic doctors’ notes, a team of physicians and nurses have embarked on a demonstration and evaluation of a project called OpenNotes. The authors describe the intervention and share what they learned from conversations with doctors and patients during the planning stages. The team anticipates that “open notes” will spread and suggests that over time, if drafted collaboratively and signed by both doctors and patients, they might evolve to become contracts for care.
Studies
Patient Access to Electronic Health Records During Hospitalization
In 2001, the Institute of Medicine recommended improving patient engagement by providing continuous care, allowing patients to be the source of control and fostering transparency with patients and families. Electronic health records (EHRs) facilitate these objectives via the use of patient portals. Giving outpatients direct access to their health information helps clinicians find errors and improves patient satisfaction, although the implications of this type of access have not been well studied in the inpatient setting. This hospital-based study evaluates the experiences of patients, clinicians (including physicians and advanced practice providers), and nurses with immediate (real-time) release of test results and other EHR information through a patient portal.