UCLA Health CIO Michael Pfeffer: Physician buy-in critical for adoption of OpenNotes

While the OpenNotes project is about giving patients greater insight into their care, it has to be a physician-driven project, says Michael Pfeffer, CIO at UCLA Health.

"It cannot be an IT project; it really needs clinician leadership," he tells FierceHealthIT.

Fortunatley for the Los Angeles-based organization, it has very engaged physician leadership driving the project when it was implemented last summer, Pfeffer says.

So far the pilot at UCLA has been seen in a positive light, according to Pfeffer.

"We don't know for sure that there's truly any outcomes yet from doing something like this, such as improving medication compliance. What we do know is that patients who have access to their notes find it very important to the point where they would seek out physicians in the future that only have that kind of technology present," he says.

In addition, Pfeffer calls the initiative very important for encouraging collaboration in care among patients, physicians and other clinicians as part of the medical home.

To kick off the program, he says IT personnel partnered with an energetic group of primary care physicians who were willing to take on the pilot.

The notes can be visible to patients in the health system's patient portal, myUCLAhealth, almost immediately after they are seen in the clinic, he adds.

The pilot started with about 30 physicians and all of their patients, a number in the low thousands.

Acceptance from those physicians hs been positive, Pfeffer says.

However, it has made the physicians more aware of what they put in their notes, he adds. They don't want to hide anything, but there is a change in the language they use to make it more patient-friendly. That's a "significant change" for the doctors, according to Pfeffer.

UCLA Health is hoping to roll OpenNotes out enterprise-wide for all outpatient visits, Pfeffer says.

However, one difficulty the health system discovered with the program was the role of residents in the process. Because UCLA Health is a training facility, residents often see patients along with attending physicians.

"We wanted to make sure that patients wouldn't see preliminary notes by residents that haven't been reviewed and signed off by an attending," Pfeffer says. "That was one thing that had to be worked out--the ability to have patients only see those finalized notes. [We] were able to make sure that the electronic health record accommodated that."

As far as the future of programs like OpenNotes, success is all about how well the contribute to patient engagement.

"How do we engage patients with technology more and in ways we've never dreamed of? I'm really excited about these things," he says.

Editor's Note: Read the first part in this two-part series, focusing on Milwaukee-based Columbia St. Mary's experience with OpenNotes. 

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