Initiative gets $10M in funding to expand patient access to doctors’ notes

Could something as simple as allowing patients access to their physicians’ office visit notes dramatically impact health care? The founders of the OpenNotes initiative, which encourages physicians and other clinicians to allow patients access to the visit notes, says that initial evidence indicates that such access may help to improve health care in a variety of areas by making patients feel more knowledgeable and in control of their care and could even improve patient safety.

The idea appears to be catching on, as the initiative is getting support from four major philanthropic foundations that announced they will be providing funding to expand the access to clinical notes to 50 million patients across the country. The Cambia Health Foundation, Gordon and Betty Moore Foundation, Peterson Center on Healthcare, and the Robert Wood Johnson Foundation (RWJF) announced they will be making $10 million in new funding available to assist with expanding the scope of the project.

Experiment

OpenNotes is a national initiative that began as a yearlong experiment that sought to discover how patients felt when doctors shared their visit notes with them. The project was based at Harvard Medical School and Beth Israel Deaconess Medical Center (BIDMC) and was funded primarily by the RWJF. The initial study began in 2010 and included 100 primary care physicians and 20,000 patients. The physicians offered their clinical notes to patients at BIDMC, Harborview Medical Center, and Geisinger Health System.

After a year, 99 percent of patients wanted to continue to view their visit notes and not one physician asked that access to the notes be turned off. Patients who had access to their notes reported that they felt more in control of their care and had more knowledge and understanding about their medical conditions. Additionally, more than two-thirds of the patients who were on medications during the study improved how they took them. These findings were supported by a study that discovered that patients who were treated for high blood pressure and were offered access to their clinical notes were more likely to fill their prescriptions than those patients who did not have access to their notes.

OpenNotes plans on expanding its research into how access to visit notes can affect health care. The initiative is examining whether shared notes could help with patient safety by allowing patients to spot and correct medical records errors. It is also studying whether access to notes can assist caregivers in optimizing care and help mental health patients.

Additional funding

Since the initial experiment, OpenNotes has expanded beyond primary care and now includes five million patients across the country, who now have access to their visit notes. The additional funding from the national philanthropies will assist in “dramatically expanding” the scope of the program. The funding will provide support over the next three years to help OpenNotes assist health care providers in adopting the practice. The funding will also help the project reach more consumers and evaluate the initiative’s impacts on health outcomes and costs. The imitative will work with an advisory body in order to effectively target health care organizations, consumer advocacy groups, clinicians, and consumers.

Benefits

The co-founder of OpenNotes and Assistant Professor of Medicine at Harvard Medical School (HMS) and BIDMC, Jan Walker, RN, MBA, said, “Our research shows increasingly that patients can benefit greatly from reading the notes taken during a medical visit. They tell us they feel more in control of their care and are more likely to follow up on recommendations.” Walker added, “This has enormous implications for improving the quality and costs of care. Moreover, we’re learning that having a second set of eyes on the record may be an important way to improve patient safety.”