Study: Use of OpenNotes increases safety, patient engagement

Through five years of experience with OpenNotes, which allows patients access to the doctor's notes in their record, researchers say using the tool can increase safety, care quality and patient engagement, according to a study in The Joint Commission Journal on Quality and Patient Safety.

The OpenNotes study began in 2010 when more than 100 primary care doctors at three hospitals opened their notes to 20,000 patients, who were allowed to read their records through a secure, patient website, according to an announcement on the study.

Patients reported feeling more in control of their health, and doctors noticed little or no impact on their work flow. In addition, patients said the notes helped them to remember to take their medicine, to follow up as prescribed during their visits, and some found errors, which were corrected.

Doctors worried that their notes would become more vague, knowing patients would be reading them, and also were concerned about how patients would define errors and that the access would affect trust.

Those are real concerns that need to be addressed with education, innovation and further research, says the study's lead author Sigall Bell, M.D., who works in the division of general medicine and primary care at Boston's Beth Israel Deaconess Medical Center.

Previous research on the use of OpenNotes at three major health systems--Beth Israel, the Geisinger Health System in Pennsylvania and Harborview Medical Center in Seattle--found patients concerned about their privacy. However, that concern did not deter participants from accessing their notes.

Veterans Affairs hospitals have offered open notes since January 2013, while nine prominent health organizations in Oregon and Southwest Washington joined the OpenNotes initiative last year.

The initiative, which has grown to cover 5 million patients nationwide, will use a $450,000 grant from the Commonwealth Fund to enable patients to contribute to their own medical data, a project called OurNotes.

To learn more:
- read the announcement