Joint Provider-Patient EHR Notes to Undergo Testing

Beth Israel Deaconess Medical Center in Boston will lead a project testing the efficacy of care notes jointly developed by both providers and their patients.


Beth Israel Deaconess Medical Center in Boston will lead a project testing the efficacy of care notes jointly developed by both providers and their patients.

The project, called OurNotes, is being funded by a $457,000 grant from the Commonwealth Fund, which says the project is a "novel approach for letting patients, caregivers, and providers jointly create clinical notes and care plans within the shared electronic health record." If successful, this testing could herald a new way to improve care management for high-need, high-cost patients, according to Commonwealth Fund.

The research team will initially review previous research, interview experts, and convene focus groups to identify key elements of OurNotes and the process for co-generating clinical notes and care plans, including pre-visit histories and agendas and post-visit follow-up plans. The team will then build prototypes and pilot the program in five healthcare organizations.

Findings from the initial phase of work will be used to develop prototypes at each site and to conduct pilot testing that, in turn, will lead quickly toward formal clinical trials.

Project partners in addition to Beth Israel Deaconess Medical Center include Geisinger Health System, Danville, Penn.; Harborview Medical Center, Seattle, Wash.; Group Health Cooperative, also in Seattle, and Mosaic Life Care, St. Joseph, Mo.

OurNotes is an extension of OpenNotes, a movement to offer patients ready, online access to their clinicians' visit notes. Increasingly accepted by patients, families, providers and institutions throughout the United States, the number of patients who can read their medical notes online has risen to more than 5 million nationwide.

This change in practice follows the encouraging findings of the OpenNotes study, published in the Annals of Internal Medicine in 2012. Led by investigators at BIDMC, the OpenNotes study involved more than 100 primary care doctors and 20,000 patients in three areas of the country.

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