OpenNotes notches another big milestone, with 40 million patients now seeing their EHRs

By | July 6, 2019

OpenNotes has gained major momentum over the past decade in its efforts to convince providers that patients have the right to access the clinical notes in their electronic health records. This week, the initiative announced that more than 40 million patients across some 200 health systems are using secure portals to see their doctors’ notes.

OpenNotes has expanded broadly since it was launched in 2010 as a small pilot project at Beth Israel Deaconess Medical Center, Geisinger and Harborview Medical Center in Seattle.

And the patient empowerment “movement” hasn’t just gained size and scope. It’s continuing to show that fully transparent medical records are paying dividends for population health, patient safety and quality improvement.

“Our most recent research, published in the Annals of Internal Medicine and in the Journal of Medical Internet Research, shows that patients, particularly those from underserved populations, feel more engaged in their care and gain greater benefit from reading the notes their clinicians write,” Catherine DesRoches, executive director of OpenNotes and a researcher at Beth Israel Deaconess, said in a statement.

“These are important and exciting findings because patients who read their notes report they are more likely to adhere to their treatment plans and medications, identify documentation errors, and follow through on tests and referrals.”

Hospitals and health systems that have recently signed on with the project include Yuma Regional Medical Center in Arizona, Asante in Oregon, Group Health Cooperative of South Central Wisconsin, Premier Medical Associates in Pennsylvania and Holland Bloorview Kids Rehabilitation Hospital in Ontario, Canada.

OpenNotes initially wasn’t very popular with some clinicians, its co-founder, Dr. Tom Delbanco, John F. Keane & Family Professor of Medicine at Harvard Medical School and BIDMC, told Healthcare IT News in 2015.

“A lot of doctors told us to go to hell,” he said. “They had many fears that they said out loud. The biggest was that it would disrupt their workflow – and primary care doctors feel overwhelmed already. The second was that it would scare the hell out of their patients. Those were the two biggest fears.”

In the years since, as the movement has spread to heavy hitters such as Kaiser Permanente, Mayo Clinic and the VA and signed new vendor partners to help, the benefits have become more and more apparent, and the process has shown itself to be minimally disruptive for physicians – and of great benefit to patient engagement and quality of care.

“OpenNotes represents a significant paradigm shift for our system and for our providers,” Dr. Lee David Milligan, CIO and CMIO at Asante, said in a statement. “We now openly share clinical notes – including behavioral health notes – with patients in near real time. Patients have expressed gratitude for being able to see their clinical assessment and plans of care. They have communicated that they appreciate being informed on issues central to their well-being.”

“Note sharing seems like a relatively simple intervention, but it requires a culture shift in medicine, and that’s not easy,” added Delbanco. “But patients love it and gain important clinical benefits, and clinicians learn quickly to build it into their practice. The evidence is growing that it’s a win-win all around.”

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