As OpenNotes, an initiative that gives patients unprecedented electronic access to clinical notes, aims to grow from more than 5 million Americans currently to 50 million nationwide, clinicians have learned an important lesson—follow-up emails are critical for keeping patients engaged in their own healthcare.

That’s the finding of a two-year study of 14,000 patients—treated at Beth Israel Deaconess Medical Center (BIDMC) and Geisinger Health System—who were invited through an automated email to view their electronic notes detailing their clinic visits. Primary care physicians at BIDMC sent reminders throughout the study; those at Geisinger stopped after one year.

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