Back in 2010, a group of primary care doctors from three different healthcare organizations across the U.S. came together to try something different. The three institutions – Beth Israel Deaconess Medical Center, Geisinger and University of Washington Medicine – conducted a one-year pilot of a new concept, dubbed OpenNotes, in which providers would share their clinical notes directly with their patients.
The experiment went well, and over time, the systems expanded the OpenNotes concept to virtually all outpatient settings, including both specialty and primary care offices.
Now, these institutions have conducted a new study looking at the impact reading notes by doctors, nurses and other clinicians has had on their healthcare experience. The study has concluded that patients find such access to be very helpful in maintaining their health, particularly for some populations which might otherwise be underserved.
To perform the study, researchers performed a Web-based survey of adult patients who used a portal account and had at least one visit note available over a recent 12-month period.
All told, 22,947 patients who responded to the survey reported that they’d read one or more notes. Of this group, three out of four reported reading notes for one year or longer, and half reported reading at least four notes. Also, roughly 38% of respondents said they’d shared a note with someone else.
About one-third of overall respondents reported that their clinicians had encouraged them to read notes, and one-third told the clinicians that they had done so.
Patients in the survey who did access notes seemed happy with having access. Virtually all respondents (98%) said they thought having access to visit notes was a good idea, and 62% thought doing so would help them choose future providers.
Almost three-quarters rated note reading as very important in helping them maintain their health, along with approximately 70% saying it made them feel in control of their care, and about 66% saying that it helped them remember their plan of care.
This was particularly the case with less educated, nonwhite, older and Hispanic patients, along with individuals who didn’t usually speak English at home, who were most likely to report realizing major benefits from reading their notes.
Also of note, despite the fears of some OpenNotes critics, just 3.3% reported being very confused after reading notes, and only 4.8% were more worried.
Meanwhile, among the other 768 respondents who said they hadn’t read visit notes, roughly half reported that they’d forgotten to do so or didn’t know that access to visit notes was available, followed by 8.8% who said they were too busy, 7.2% who didn’t think reading the notes would be useful and 6.3% weren’t able to find the notes.
Among the 12% reporting another reason for not reading, most said they had no reason to do so because they trusted their clinicians, had received printed copies or had no health issues or recent visits.
In summing things up, the study noted that fewer than half of clinicians and patients actively address their shared notes during visits, but expressed hope that this practice would expand both in the US and internationally, asserting that OpenNotes “brings benefits to patients that largely outweigh the risks.”
Given that nearly 100 health systems across the US are using secure patient portals to share visit notes with more than 20 million of their patients, it’s good to see that they’re probably onto something good. With the publication of studies like these, meanwhile, adoption of note sharing may be due for another growth spurt.