Patients benefit from open access to physicians’ notes

Issue: November 10, 2012

Patients with access to notes written by their doctors reported a better understanding of their medical issues, improved recall of their care plan and being more likely to take their medications as prescribed, according to study results published in the Annals of Internal Medicine.

More than 100 doctors and 13,500 patients participated in the OpenNotes trial at the Beth Israel Deaconess Medical Center, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle. During a year-long voluntary program, doctors and patients who had at least one note available were provided with electronic links to their doctors’ notes.

Between 77% and 87% of 5,391 patients who opened at least one note and returned surveys reported feeling more in control of their care, with 60% to 78% reporting increased adherence to medications, according to study results. Feelings of worry, confusion or offense were reported by 1% to 8% of patients, while three out of five felt they should be able to add comments to their doctors’ notes and 86% agreed that availability of notes would influence their choice of providers in the future.

Five percent of doctors surveyed reported longer visits, while 8% said they spent extra time addressing patients’ questions outside of visits. Researchers found that 21% of doctors reported taking more time to write notes, whereas between 3% and 36% reported changing documentation content. Overall, no doctor elected to stop providing access to notes after the experimental period ended and fears about an additional time burden and offending or worrying patients did not materialize. Many reported enhanced trust, transparency and communication with their patients.

“Patients are enthusiastic about open access to their primary care doctors’ notes,” Tom Delbanco, MD, primary care doctor at the Beth Israel Deaconess Medical Center and Koplow-Tullis professor of general medicine and primary care at Harvard Medical School, stated in a press release. “Open notes may both engage patients far more actively in their care and enhance safety when the patient reviews their records with a second set of eyes.”

For more information:

Delbanco T, Walker J, Bell SK, et al. Inviting patients to read their doctors’ notes: a quasi-experimental study and a look ahead. Ann Intern Med. 2012;157:461-470.

Disclosure: Delbanco had no relevant financial disclosures.