The case for 'open notes'

Once regarded as infeasible, patient access to physician notes is increasingly becoming the norm, according to an op-ed published in the New England Journal of Medicine.

“Nearly 2 million Americans already have access to notes, and we anticipate that open records will become the standard of care, accompanied by electronic tools that explain medical terminology and abbreviations, translate notes into different languages and adjust for health-literacy levels,” wrote the authors, who all were involved in OpenNotes, a Robert Wood Johnson Foundation-funded initiative at Beth Israel Deaconess Medical Center that opened 100 primary physicians’ e-notes to 20,000 patients.

Initial findings from the study determined that four out of five patients read their notes, and those surveyed reported that it enabled them to better comprehend their care plans and feel more in control of their healthcare. Moreover, the majority of those taking medications reported improve adherence.

Physicians also responded positively to the development, saying they were surprised how few patients appeared troubled by the content of the notes. Most physicians did not modify the tone or content of their notes; however reporting changed in some potentially sensitive areas, including cancer, mental health, substance abuse and obesity, according to the article.

Importantly, 99 percent of patients surveyed wanted the open notes program to continue and 85 percent indicated that ready access would be important to their future choice of a provider. No physician opted to discontinue the practice, according to the op-ed.

Increasing patient engagement through transparent medical records would contribute to improvements in health, care and costs, the authors wrote. “As open notes continue to spread, and strategies and safeguards evolve, we expect that both patients and providers will benefit."

Read the editorial here.