At a time of societal fascination both with transparency and the explosion of health information technologies, a growing number of hospitals are offering, or will soon offer patients and their family instantaneous access to their doctors’ and nurses’ notes. What will this new opportunity for patient engagement mean for the hospitalist? Today, state and federal government regulations either encourage or require healthcare providers to grant patients access to their clinical information. But despite the rules embedded in the federal Health Insurance Portability and Accountability Act (HIPAA), patients often face time-consuming obstacles in their quest for access, and many providers view compliance as a burden. We suggest an alternative view: Over time, we anticipate that inviting patients to review their medical record will reduce risk, increase knowledge, foster active engagement, and help them take more control of their care. The OpenNotes trial provides clues as to how such practice will affect both patients and providers (1, 2). We anticipate that transparent records will stimulate hospitalists, PCPs, and other caregivers to improve communication throughout the patient’s hospital stay. OpenNotes offers a special opportunity for improving the patient experience after leaving the hospital as well. Open notes will be viewed by many as a disruptive change, and the best strategy for adapting will be to move proactively to create policies that establish clear guidelines, for which the authors offer some suggestions.
patient engagement
When Seeing the Same Physician, Highly Activated Patients Have Better Care Experiences Than Less Activated Patients
By Jessica Greene, PhD, Judith H. Hibbard, PhD, Rebecca Sacks, and Valerie Overton, CNP, RN Patients who have the knowledge, skills, and confidence to manage their health and health care report better health care experiences than patients with lower levels of “activation” who see the same clinicians. Findings from this Commonwealth Fund–supported study suggest that care…
Health IT Buzz: Building Momentum: Expanding Patient Access to Medical Records
By Lygeia Ricciardi, EdM Giving patients (or, more broadly, consumers), easy electronic access to their own health information is a key step in empowering individuals to be more engaged partners in their health and their healthcare, including: coordinating care among multiple providers, making sure medical records are accurate and complete, and using apps and tools…
Open Health News: VHA Joins ‘OpenNotes’ Effort for EHR & PHR Systems
The Veterans Health Administration (VHA) has joined the Robert Wood Johnson (RWJ) Foundation’s ‘OpenNotes’ initiative as a partner along with other healthcare provider organizations – Beth Israel Deaconess Medical Center, Harborview Medical Center, Geisinger Health System, MD Anderson Cancer Center . These organizations are all fully committed to giving patients online access to clinical notes.…
OpenNotes: Hospitalists’ challenge and opportunity
Dr. Henry Feldman and co-authors explore the implications of giving patients on the hospital wards real time access to notes. This article discusses opportunities to use shared visit notes to partner with patients and their caregivers, at the bedside and after discharge. An early view of, “OpenNotes: Hospitalists’ Challenge and Opportunity,” published in the Journal…
Globe 100 Innovators: Doctor’s notes, demystified
By Cindy Atoji Keene What is the doctor scribbling down in the chart? Many patients have probably wished they could sneak a peak into their medical records. Being able to do so is like a proverbial shot in the arm, said physician Tom Delbanco and Jan Walker, founders of OpenNotes at Beth Israel Deaconess Medical Center.…
Advisory Board: In Record Time: How an EHR Changed My Patient Experience
I’ll be the first to admit it, I was a bit put off when the receptionist said, “You need to call back the day you’d like to see the doctor.” With such short notice would I even get to see my new family doctor, or would I be triaged to one of his colleagues? Given…
Geisinger Expands OpenNotes
More than 168,000 Geisinger Health System (GHS) patients have access to their doctors’ notes for the first time through the secure MyGeisinger online patient portal. Geisinger expanded OpenNotes in May 2013 due to the initiative’s overwhelming success. As of November 2013, the expansion of OpenNotes now includes more than 1,000 Geisinger clinicians, encompassing all of…
Interval Examination: Moving Toward Open Notes
Despite periodic efforts over almost 5 decades, the idea of having patients review and contribute to their medical records has failed to take hold, even though such practice might engage patients more actively in maintaining their health and managing their care and might also improve quality of care and patient safety. Contemporary trends toward increased transparency, accompanied by evolving health information technologies, provided an opportunity for us to conduct a study examining the effects on both patients and primary care physicians (PCPs) of inviting patients to read their doctors’ visit notes. Bolstered by encouraging findings from this study, and with the goal of informing those who might join in further inquiry, we outline in this “interval examination” challenges we are encountering and strategies we are employing as we explore wider implementation of this practice.
RWJ Pioneer Blog: Why the VA Embraces OpenNotes
Earlier this year, the Department of Veterans Affairs (VA) embraced OpenNotes, enabling more than 1 million veterans who currently have access to the VA personal health record to view or download their own medical notes along with their health record information via the My HealtheVet Blue Button. In a recently published study in the Journal of Medical…
