Allowing patients to access notes from their doctors will help to "foster truly collaborative patient-clinician relationships," even while more research is needed on the programs, according to an article at BMJ.
There is a compelling case for further study and implementation of programs that allow open clinician notes, writes Jan Walker, assistant professor of medicine in the Division of General Medicine and Primary Care at Harvard Medical School; Tom Delbanco, professor of medicine at Harvard Medical School; and Michael Meltsner, law professor at Northeastern University School of Law.
The three professionals evaluated studies conducted on the OpenNotes program and comments from clinicians using that and similar notes programs.
The original OpenNotes experiment was first piloted in 2009 at a handful of health systems, including Boston-based Beth Israel Deaconess Medical Center, Geisinger and Seattle-based Harborview, and has now expanded to cover 5 million patients nationwide. It allows patients to read the honest, uncensored notes captured in their medical records.
Patients increasingly are embracing the program, especially to share health info family, friends or caregivers, according to a study published last fall in the Journal of Medical Internet Research, which examined patient use of OpenNotes. The program also is expanding to become more interactive, enabling patients to contribute to their own medical data.
Walker, Delbanco and Meltsner say that looking at the different physicians and patients taking up the practice of open notes "suggests it is a concept widely applicable to healthcare."
But they do acknowledge that there needs to be more research, especially because many doctors are looking for evidence about the impact open notes have on care outcomes.
"This is methodologically challenging; opening notes has a wide range of possible effects, and they will be difficult to isolate," the authors say. "Little is known about the long term effects of open notes, but our observation of implementations by multiple providers shows that clinicians adapt readily."
In addition, they say, some questions that will need to be addressed include:
As people gain better understanding of their condition, do open notes reduce or fuel their demand for investigations?
- How often are mistakes in documentation identified and corrected?
- Are there fewer missed appointments or fewer requests to be seen by a doctor?
- Does clinically important communication and trust between patients and clinicians increase?
To learn more:
- read the article