More than 5 million patients nationwide now have electronic access to their clinicians' visit notes through an effort that allows them to read these medical notes online after an appointment.

The use of technology to better engage patients in their own care is at the heart of OpenNotes, according to John Mafi, M.D., an internal medicine fellow at Beth Israel Deaconess Medical Center in Boston, where outpatient notes written by clinicians in primary care and all medicine subspecialties are being shared. These notes are available on a secure website where patients can manage their healthcare online.

Led by researchers at Beth Israel Deaconess Medical Center, the results of an OpenNotes study that included more than 100 primary care physicians and 20,000 patients in three areas of the country was published in 2012 in the Annals of Internal Medicine

“Lots of patient enthusiasm, self-reported clinical benefits, and surprisingly not a lot of impact on primary care physician workflow,” were among the initial findings of the initiative Mafi told an audience earlier this week at the ONC Annual Meeting in Washington. He described OpenNotes as a “movement across the country” for better patient engagement and ultimately improved care.

According to Mafi, after an outpatient clinic visit patients typically forget between 40 percent and 80 percent of what their doctors told them during their appointments and much of what patients do remember is factually incorrect. With OpenNotes, he said “patients feel more in control of their own care and remember the plan of care better when they actually read their doctor’s visit note.” Further, two-thirds of patients reported better medication adherence due to reading these notes.  

Mafi said the next phase of OpenNotes is OurNotes, in which patients and physicians will “jointly” contribute to their own records. Studies have shown that when patients directly input their own data that information is more accurate, he revealed. “The hope is that this frees up time during visits to allow for more connections between patients and doctors and ideally shared decision making.”

Funded by a $500,000 grant from the Commonwealth Fund, OurNotes is currently in the “building phase” of the project which will develop prototypes at five partner sites to conduct pilot testing, Mafi said. In addition to Beth Israel Deaconess Medical Center, OurNotes partners include Geisinger Health System, Danville, Penn.; Harborview Medical Center, Seattle, Wash.; Group Health Cooperative, also in Seattle, and Mosaic Life Care, St. Joseph, Mo.

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