Electronic Health Records

Use & Optimization News

Co-Authored EHR Notes to Redefine Patient Engagement

By Jennifer Bresnick

Beth Israel Deaconess Medical Center, (BIDMC), a leader in the OpenNotes movement, is taking patient engagement one step further with a new grant that will explore the notion of letting patients actively contribute to their EHR documentation.  With a $450,000 grant from The Commonwealth Fund, BIDMC and a team of partner organizations will develop OurNotes as a way to allow patients to put their own stamp on their primary care medical records and involve them more deeply in care decisions.

“We know that increasing patient engagement is a critical component of improving health care, and we hope to build on BIDMC’s well-established work in this area,” said Anne-Marie Audet, MD, Vice President at The Commonwealth Fund. “This research will explore the potential for OurNotes to help improve care among the most medically complex patients–those with multiple chronic health conditions.”

“This is really building for the future. We envision the potential capability of OurNotes to range from allowing patients to, for example, add a list of topics or questions they’d like to cover during an upcoming visit, creating efficiency in that visit, to inviting patient to review and sign off on notes after a visit as way to ensure that patients and clinicians are on the same page,” added principal investigator Jan Walker, RN, MBA, Division of General Medicine and Primary Care at BIDMC and Assistant Professor of Medicine at Harvard Medical School.

OpenNotes has been one of the most successful ways to allow patients to become more actively engaged in their care, and has seen high levels of acceptance from patients and physicians alike. After getting its start at BIDMC and the Geisinger Health System, the movement recently expanded to include nearly half a million Kaiser Permanente members in the Pacific Northwest.  The BIDMC pilot of OpenNotes led 80% of patients to state they feel more in control of their care, and promoted 70% to improve their medication adherence.  Sixty percent of patients in the 2013 program added that they would be very interested in editing their record, which OurNotes will now allow them to do.

“Our research has shown — and feedback from patients continues to confirm — that patients benefit from reading their visit notes.  For example, patients say they have better recall of the treatment plan, feel more in control of their health care, and report improved adherence to medications,” Walker said. “We believe that OurNotes, which will enable patients to contribute to their own medical records, has the potential to further enhance communication and engage patients in managing illness more effectively and efficiently, leading to improved patient safety and quality of care and potentially, to lower health care costs.”

The grant will allow BIDMC to work with Geisinger, Harborview Medical Center and Group Health Cooperative in Seattle, and Mosaic Life Care in Missouri to gather insight into what physicians would like to see from their patients as well as how patients would prefer to contribute their data to the communal record.

“We envision OurNotes as a therapeutic intervention that will prove effective over time for a wide range of patients, especially those struggling with chronic health concerns,” said Jonathan Darer, MD MPH, Chief Innovation Officer at Geisinger Health System, who is a co-investigator on the project. “We expect this process to enlighten our understanding of patient and family engagement and its role in reducing healthcare costs, increased shared accountability, improving the health of those with chronic illness and multiple comorbidities and, most importantly, enhancing the overall patient experience of care.”

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