OpenNotes is an exciting multi-center trial funded through a generous grant from the Robert Wood Johnson Foundation. This one-year intervention will allow patients to access their primary care physician’s visit notes through an electronic medical record. The study is being undertaken at 3 primary academic medical centers, with staff (Click Here) from 5 major institutions participating in the scientific part of the trial. OpenNotes is designed to explore this exciting area of medical transparency and how it affects the doctor-patient relationship.

What Problem Does OpenNotes Address?

As the general trend toward transparency grows, providers with electronic medical records increasingly allow patients to view online laboratory results, medication lists, and other parts of the medical record. However, though patients own their medical records, providers rarely share doctors’ visit notes with them.

What is the OpenNotes Intervention?

• OpenNotes is a 12-month project starting early 2010 in which PCPs and their patients will share visit notes through an electronic medical record
• OpenNotes will be conducted at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in rural Pennsylvania, and Harborview Medical Center in Seattle
• We aim to recruit 75-130 PCPs and 15,000-25,000 highly diverse patients

Based on others’ experiences, we hypothesize that OpenNotes will:

• Create a more transparent and democratic health care environment
• Enhance patient-doctor communication
• Reduce the likelihood of litigation by increasing accuracy of provider notes
• Increase shared decision-making and patient satisfaction with care
• Help patients and their families become more actively involved in promoting health and managing illness
• Improve patient recall, which is often weak following an office visit that is frequently emotionally charged

How will the OpenNotes evaluation work?

Giving Patients Access to Their Notes:
After a patient’s visit, the doctor’s notes will be posted on the patient’s electronic medical record. The patient will then be able to see what notes his/her doctor has written and send messages to the provider about those notes. We hope this will help patients better understand what their doctor is thinking about their health issues.

Data Collection:
Prior to the study start date, we conducted focus groups with physicians and patients to learn about current attitudes toward sharing visit notes. Before and after the study begins, we will ask participating and non-participating doctors and patients to complete surveys about their expectations and ideas about OpenNotes.

Feedback:
We also hope to collect anecdotes and comments from participating doctors and patients – Feedback will be provided at each site through the various patient portals!