This summer, a team of 100 primary care physicians across the country will embark on the "OpenNotes" initiative. OpenNotes will give 25,000 patients the chance to read doctors' notes on their medical records via a secure Internet portal.

The OpenNotes pilot program is designed to determine if access to doctors' notes will result in improved doctor-patient communication. For doctors, notes serve as a reminder of the unique characteristics of the patient, their medical history, and their care. For patients, doctors' notes may help to clarify issues or explain care approaches. The hope is that inviting patients to review their notes could improve their understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes.

"I think this may be a real step in transforming the patient and provider relationship," said Tom Delbanco, MD, Professor, Harvard Medical School and Physician (Former Chief) Division of General Medicine & Primary Care, Beth Israel Deaconess Medical Center in Boston.

Some fear that patient access to physicians' notes could have negative consequences, such as confusing or worrying patients.

"I think patients will not be very surprised by what they see," said Dr. Delbanco. "In many ways, the note is supposed to mirror what happened in the encounter. But patients will probably get insight into what's worrying their doctor and what their doctor's intentions are. They also may find things for which they want more explanation. We don't know exactly what will happen. But we are excited to find out if OpenNotes can improve care from both the physician and the patient perspective," said Dr. Delbanco.

The program will be evaluated primarily through web-based surveys. Researchers believe that if the pilot goes well, OpenNotes could become the standard in years to come.

Readers of Annals of Internal Medicine can take a survey to provide their thoughts about OpenNotes at the Annals home page.

Source:
American College of Physicians