Electronic Health Records

Adoption & Implementation News

OpenNotes Pilots Show Value of Patients Annotating EHRs

By Vera Gruessner

With the advent of EHRs, mobile health products, telehealth services, and other health IT innovations, it comes as no surprise that physicians have also provided patients with electronic access to their written notes.

The OpenNotes study started in 2011 and immediately showed patients feel better about and are more likely to adhere to their medications after given the opportunity to view doctors’ notes. The results published in the Annals of Internal Medicine journal show that the majority of patients — almost 12,000 out of about 13,500 participants — opened at least one note during the study. Additionally, at least 60 percent of patients on medication reported greater prescribed drug adherence while around 80 percent of participants stated they exhibited greater control of their care.

After the first successful run of OpenNotes, the researchers from Beth Israel Deaconess Medical Center decided to attempt a pilot program that allowed certain patients to view psychiatric notes, 90.9wbur reported.

In general, there has been a greater movement toward allowing patients to see their medical records, which has clearly spurred these OpenNotes projects. The next step the researchers are working on is to allow patients to comment and add annotations to their health records.

Think of it this way: the latest OpenNotes program will allow patients to collaborate with doctors in a similar way to coworkers who contribute toward a project through Google Docs. The researchers from Beth Israel Deaconess obtained a $450,000 grant from The Commonwealth Fund and plan to create a new interface that allows patients to comment on their own medical records.

This type of communication with one’s physician could be a major stepping stone toward revolutionizing patient care. Reporter Carey Goldberg from 90.9wbur spoke with Jan Walker, Co-Director of the OpenNotes project and a researcher at Beth Israel Deaconess and Harvard Medical School, to discuss some of the benefits of their latest project.

“If you’re a patient, you might have gone to the doctor with an infection and been given antibiotics,” Walker explained. “So you might write down in this record when your symptoms abated or how you did with the antibiotics. Similarly, you might read in your notes that the doctor reminded you to exercise, and you might keep track of your exercise regime to discuss that with your doctor at the next visit.”

Walker further elaborated on the fact that patients could create an agenda about their ailments before going to their doctor’s office. This would give the physician an opportunity to prepare and address all concerns during the visit. Additionally, if anything was recorded in error, a patient would be able to fix these mistakes. This OpenNotes system could play a significant role in improving patient safety.

As of right now, many patients have the ability to send secure emails or messages directly to their physicians, nurses, or other healthcare providers through patient portals. The OpenNotes program could become a different avenue for patients to communicate with their doctors and could supplement patient portals significantly.

The hospitals that will take part in this small pilot program include Pennsylvania-based Geisinger Health System, Beth Israel Deaconess Medical Center in Boston, Seattle-based safety net hospital Harborview, Missouri-based Heartland Health, and Group Health in Seattle.

The researchers hope that this latest program will allow patients to be active participants in their own care and become more aware of disease prevention and early intervention.




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