Patients Want Access To Physician Notes Despite Privacy Concerns

While privacy concerns remain, patients’ desire to access their medical records online seems to outweigh those concerns, according to a study reported in iHealthBeat.

The study, which was published in the Journal of Medical Internet Research, included 3,874 primary care patients at Beth Israel Deaconess Medical Center, Geisinger Health System and Harborview Medical Center. Each of these institutions implemented OpenNotes, a portal which allows patients to read the notes written by their doctors following office visits, e-mail correspondence and phone calls. The patients were able to view the notes via the portals where other parts of their medical records are stored.

Researchers interviewed patients at baseline, prior to their using the OpenNotes portal. They were interviewed again after a one year period during which they were able to use the OpenNotes portal to review the notes doctors made during their visits.

Privacy remained a concern throughout the study period, iHealthBeat noted. At the study’s outset, about 33 percent of OpenNotes project participants reported having concerns about privacy;  meanwhile, almost 37 percent said they were concerned about privacy after the one year period of using the portal.

After using the portal  for a year, 15.5 percent of patients said they were more concerned about privacy, while 12.7 percent said they were less concerned about privacy.

That being said, study participants were still very enthusiastic about having access to the notes. In fact, at the study’s end, 99 percent of participants said they wanted continued access physician notes, despite their initial privacy concerns.

In April of last year, when I first wrote about this project, I  predicted that patients would become very attached to the level of intimacy OpenNotes would offer with their providers.  It seems that this has come to pass. If 99 percent of patients want to continue with the project despite having privacy concerns, that’s a ringing endorsement of the concept. Now, I’m curious as to whether other institutions will get on board.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • It’s a great idea to offer this to the patients, because it can be a good tool for reinforcing advice (i.e. avoid salt), ongoing preventative maintenance (aspirin regiment for a healthy heart), if they have access to their check-ups and office visits.
    Online security will always be a hot topic, and I hope that the healthcare industry does their due diligence to implement security not just within their own patient portals, but also the health exchanges that are growing by leaps and bounds. Not only do patients need to be cautious of the security for personal access, but when a patient goes to another healthcare network, whether locally, regionally, or out-of-state, these HIE’s need to be able to securely transmit the patient’s data back & forth.
    On a side note, not all patient data is accessible through patient portals. You have access only to what the doctor allows, which is a general overview of the visit. I work in the healthcare industry and have been a part of the design & implementation of an EHR, so I know this for a fact. Doctors, nurses, MA’s, office staff all can make notes in the patient’s chart, which cannot be seen by the patient. Also, there are parts of the chart that are also not published to the patient through a portal, they would need to request this information separately.

  • Curious as to why this is so much different than financial data – I can opt in or out depending on how sensitive I perceive my data to be. But I can get my credit history, investment information, purchasing history all online if I choose. I have purchased lab tests and received the results online with no difficulties; whereas when a doctor orders results, I’m only contacted if there is a problem – I never see those results unless I ask for them. I think patients should be able to make this informed choice.

    As an RN, I never wrote anything in a patient’s chart that I couldn’t back up with clinical evidence. I’m still not sure why we don’t want patients to see this information as it’s used to diagnose, treat, and bill. We’ve got to get out of this mindset that information about me belongs to someone else.

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