OpenNotes Project Explores Medical Records Transparency

Have you read your doctor’s notes from your last visit?

Three medical facilities with over 100 of their Primary Care Physicians and 20,000 of their patients are evaluating the impact of sharing encounter notes in the OpenNotes project. The facilities are Beth Israel Deaconess Medical Center (BIDMC) and its associated primary care practices in Boston, MA, Geisinger Health System (GHS) and its primary care practices in rural Pennsylvania, and Harborview Medical Center (HMC), a county hospital and safety net provider in Seattle, WA. The project is supported by grants from the Robert Wood Johnson Foundation Pioneer Portfolio, the Drane Family Fund, the Koplow Family Foundation, and the Katz Family Foundation.

The OpenNotes project is a trial and demonstration exploring what happens when your medical records become transparent and available to you. Starting back in the summer of 2010 patient of the project facilities were invited to read their primary care physician’s note of the visit and what followed in emails and phone calls. Through secure patient portals the patient can view notes as well as other parts of their medical record.

There were a lot of preconceived notions about what would happen. For the doctor, it might be an additional burden. Would they worry about editing the notes? Would they change the content of what they might otherwise put in the notes? For the patient, would they even read the notes? Would they share them with others? Would they be helpful, confusing, or even make them worry more. In the end, would they help the patient deal more effectively with their personal health?

The study conducted for the trials proved that more than 90% of the patients wanted to see their doctor’s notes. On the other hand, from the three facilities the 254 doctors were not so willing to share. Only 114 agreed to participate while 140 declined. But of those that participated 81% said they thought the transparency was a good idea and good for the patient. And not surprising almost 97% of the patients thought access to their records would be helpful. Bringing a new meaning to “doctor knows best”? Or just more on our new favorite phrase, “patient engagement”?

Although the project is still going on, the first year of the project ended last summer. The OpenNotes team plan to report on the first year findings soon.