Practice Notes

Should providers share medical notes with patients? Patients and physicians say yes.

by William Hudec

Patients frequently complain that doctors’ visits are too short, medical terminology is too complex, and details for appropriate medication are too complicated. 

But what if there was a way for patients to press "rewind" and replay the key pieces of their most recent doctor’s appointment?

That’s the idea behind OpenNotes, a program that allows patients to review important medical information at their convenience. Patients log on through a secure, online patient portal, and can view physician observations, diagnoses, prognoses, instructions, test results, prescriptions, next steps, and email communications.

A year-long demonstration project conducted by Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Pennsylvania, and Harborview Medical Center in Seattle enlisted over 100 physicians and nearly 15,000 patients to test reactions to OpenNotes. 

The project was well received by nearly all participants, with 99% of patients wanting continued access to their notes. Similarly, no physician chose to stop using OpenNotes when offered the opportunity to do so.

It turns out that making providers’ notes open to patients came with few drawbacks and many benefits for both doctors and patients:

  • Patients overwhelmingly reported better understanding of health and medical conditions.
  • Very few patients reported being confused, worried, or offended by what they read in the notes.
  • Many physicians reported strengthened relationships with patients.
  • Very few doctors reported significant impacts on workflow.

The potential to transform medicine

Recently, an editorial in The New England Journal of Medicine provided an update on OpenNotes. The authors, representing the three health systems from the original demonstration project, argued that OpenNotes should and will be the new standard of care.

By making patients’ health records fully transparent, OpenNotes has the potential to transform medicine: reducing information asymmetries and unequal decision-making dynamics will pave the way for truly patient-centered care.

The Advisory Board’s Health Care IT Advisor published a research brief that explores how this transparency could shift the patient-physician relationship.

Here are some of their key findings:

  • OpenNotes changes the way doctors write, for the better. Use of the program encourages physicians to produce comprehensive—and comprehensible—patient notes and could counter the growth of poor documentation that EMR has created.
  • OpenNotes engages patients by speaking their language. The program could spawn new technologies to serve patients by explaining complex medical terminology, offering language translation services, and starting more open conversations before, during, and after their visit.
  • OpenNotes improves patient outcomes through transparency. Use of the program could improve patient safety by allowing patients and family members to correct and prevent errors. This type of engagement has proven to improve health outcomes.

While some physicians remain concerned about disclosing sensitive details to patients and some patients worry about privacy and security, the OpenNotes experience suggests these concerns are secondary.

Nearly 2 million Americans already have electronic access to clinician notes, and this number is expected to rise dramatically over the next five years. As a low-cost, low-tech patient satisfier, will your medical group be the next to implement OpenNotes?

Learn More

To learn more about OpenNotes and other innovations in the primary care space, read our study, Redesigning the Primary Care Clinic.

To hear more about how to prepare your medical group for the future, register for our webconference, How to Prepare the Clinic for Successful Team-Based Care.


Interested in Membership?

Learn more about the Medical Group Strategy Council and how we can help your organization. Contact us.