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About OpenNotes
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A national movement with more than 12 million patients with access to
their clinician notes
Includes thousands of doctors, nurses, therapists, trainees, physician
assistants, case managers, and other care givers sharing notes
Began with a three-institution study in 2010, involving 105 primary care
physicians and 20,000 of their patients.
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About the OpenNotes Study
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1-year Demonstration Project summer 2010 – summer 2011 (and still ongoing)
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Patients invited to view their PCPs’ signed notes via secure portals (only notes signed
during the project – not retroactive)
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Each patient notified automatically via secure e-mail message when a note was
signed, and later reminded to review note(s) before next visit
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Patients and doctors completed surveys before and after, and we collected
administrative data (portal clicks, e-mail volume)
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About the OpenNotes Study
Three Principal Questions
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Would OpenNotes help patients become more engaged in their care?
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Would OpenNotes be the straw that breaks the doctor’s back?
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After 1 year, would patients and doctors want to continue?
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About the OpenNotes Study
Three out of four patients reported
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taking better care of themselves
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understanding their health and medical conditions better
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feeling more in control of their health and health care
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being better prepared for visits
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doing better with taking their medications as prescribed
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The Bottom Line for Patients
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They want to read, understand, and be educated about their notes
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99% of patients want to read their medical notes online
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4 out of 5 patients say that the availability of OpenNotes would impact
their choice of provider
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OpenNotes does not change the confidential relationship between the
patient and provider, but about 40% of patients share notes with family,
caregivers/care partners, and others involved in their care
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What did we learn from the clinicians?
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About 50% expected a change to workflow, but those concerns did not bear out.
There was minimal impact on workflow with only 3% reporting longer visits or more
questions.
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Patients were rarely worried or confused by notes.
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Clinicians reported little change in the way they wrote notes, and those who did,
remarked the changes were minor and doable, such as using less jargon and spelling
out abbreviations and acronyms.
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3 out of 4 doctors said they would like their patients to see notes online, and at the
end of the trial, not one doctor asked to stop sharing notes
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The Power of Open Notes
“Nothing About Me Without Me”
A new medicine
that brings benefits …
and risks
A catalyst for change…
and not only
in ambulatory care
An opportunity to
Partner with patients
And improve safety
Delbanco, Berwick, et al., Health Expectations, 2011
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Factor: Patient Safety
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Factor: Medication Adherence
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Factor: Caregivers
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Factor: Caregivers
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Factor: Mobile Users
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Factor: Mental Health
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About OpenNotes
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Supported by major combined grant from four leading foundations
“…a remarkably simple way to substantially improve health care by fueling transparency and communication…a ‘musthave’ for tool for everyone…” Media Statement, December 15, 2015
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