Which EHR companies have OpenNotes functionality?
As EHR companies update their products to meet regulatory standards and the evolving needs of clinicians, insurers, and patients, many are making it easier to share visit notes with patients. Here are the companies we know support OpenNotes functionality.
Before You Begin
We regularly hear from patients that the EHR and patient portal user experience can be challenging, and they often give up before finding what they need. We recommend that an assessment of existing EHR functionality include examining the patient interface to see how patients experience the portal. We also suggest involving patient advisors in decision making to ensure that the values and concerns of all who utilize the EHR will be represented.
"Must Have" Functionality
These functions should be considered to give health systems and clinicians the flexibility they need to successfully implement OpenNotes and optimize patient engagement.
- Opt-in and opt-out
Building in the capacity to opt-in or opt-out individual providers, departments, clinic locations, provider-types, and encounter types, gives health systems the ability to accommodate various approaches and circumstances.
- Sensitive Information
Providing the option to hide a note by clicking a check-box (“do not share”) and/or have a designated encounter type that is “not shared” allows clinicians to document patient-sensitive information.
“Our experience is that over time less than .1% of clinicians choose to hide a note, still it gives them peace of mind to know the option is there.”— Homer Chin, MD, OpenNotes
- Discharge Summaries
Providing functionality to release discharge summary at the time of signing facilitates continuity of care. Even if the physical paper is misplaced, clinicians, patients, and caregivers will be able to rely on online access to the care plan and instructions immediately and whenever they are needed.
- Patient Reminders
Incorporating the ability for health systems to send automatic reminders to patients when notes are available significantly increases the likelihood that the notes will be used by patients. An additional feature is the option to show patients what they have reviewed and what they have not reviewed and allow a one-click access to new information.
“QUOTE from Vermont PFAC about how members advocated for reminders to be turned on when OpenNotes was rolled out.”— Vermont PFAC member
- Proxy Access
Providing proxy access functionality allows health systems to maintain patient privacy while giving patients control over who can access their health information.
Building in the functionality to identify and triage inaccuracies and potential errors in the record helps streamline the process patients use to request corrections to the chart as well as the process health systems use to address patient concerns. NOTE: The message with the correction should go to the provider and to HIM (Health Information Management). The provider should be given time to decide whether or not to edit the note, and if the clinicians does not make the requested change by the deadline, HIM will annotate note with “patient requested following change: XYZ.”
- Monitoring Portal Utilization
The capability to monitor metrics such as percent of patients with portal access, how often the portal is accessed, percentage of patients reading their provider notes, numbers of requests for corrections, etc. allows health systems to assess strategies and incorporate process improvements.
"Good To Have" Functionality
These functions support enhanced bi-directional communication between patients and clinicians.
- Patient Contribution
Providing the capability to add comments or to suggest corrections helps patients communicate important health information in a more timely way and ensures that the information is integrated into the patient’s health record.
NOTE: The provider is notified and has the option to “accept” the patient generated information or leave as is.
- Notes in the Inpatient Setting
The ability to release all inpatient documents (consults, progress notes, labs, radiology and pathology reports) right away, or after a delay of 2 – 4 days.
- Patient Preferences
Giving patients the ability to change settings affecting the frequency of reminders or to set up information filters for proxies, etc. helps the patient manage the flow of information and can improve patient satisfaction.
- Provider ability to see when notes have been read
The option of having the note in the EHR change color, or to be marked in some other way, allows the provider to see which notes the patient has read.
- Reference Links
The ability to provide links from items in the record (medications, diagnoses, lab names) to reference information that will explain those items allows patients to get important information with a single click and ensure that they are going to trusted sites for medical information.
- Order status and results
Providing the functionality to show outstanding orders, referrals, etc., and allowing patients to single click to read the status and the results when they are available, streamlines processes and makes it easier for patients to follow through on the care plan.
- Automated Note-Checking
The option to have the system check the note for confusing language, difficult to understand abbreviations, etc. at the time of note signing, giving the clinician the opportunity to edit the note before submitting.
- Increasing Portal Adoption
The functionality to make it easier for patients to sign-up for the patient portal by providing promotional and educational material including posters, handouts, videos that can be adapted by organizations for their specific needs.