OpenNotes Releases Findings on Sharing Patient Encounter Notes

Study shows patients want transparency in their medical records.

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.

A press release was issued last week from the OpenNotes project, Beth Israel Deaconess Medical Center-led study finds little impact on doctor workload from OpenNotes. The findings from all three sites of Beth Isreal Deaconess Medical Center were published in the Oct. 2 issue of the Annals of Internal Medicine. There were 105 PCPs and 13,564 of their patients who had at least 1 completed note available during the intervention period.

The results published were:

  •  11,797 of 13 564 patients with visit notes available opened at least 1 note (84% at BIDMC, 92% at GHS, and 47% at HMC)
  • Of 5391 patients who opened at least 1 note and completed a post intervention survey
  • 77% to 87% across the 3 sites reported that open notes helped them feel more in control of their care
  • 60% to 78% of those taking medications reported increased medication adherence
  • 26% to 36% had privacy concerns
  • 1% to 8% reported that the notes caused confusion, worry, or offense
  • 20% to 42% reported sharing notes with others
  • The volume of electronic messages from patients did not change.
  • After the intervention, few doctors reported longer visits (0% to 5%) or more time addressing patients’ questions outside of visits (0% to 8%), with practice size having little effect
  • 3% to 36% of doctors reported changing documentation content and 0% to 21% reported taking more time writing notes.
  • Looking ahead, 59% to 62% of patients believed that they should be able to add comments to a doctor’s note.
  • One out of 3 patients believed that they should be able to approve the notes’ contents, but 85% to 96% of doctors did not agree.
  • At the end of the experimental period, 99% of patients wanted open notes to continue and no doctor elected to stop.