7 things to know about BIDMC's OpenNotes program

Approximately five years ago, clinicians at Boston-based Beth Israel Deaconess Medical Center started OpenNotes, an initiative that provides patients access to clinicians' notes in an effort to accelerate transparency, as well as improve patient safety.

The researchers recently released key findings from the pilot program, which largely demonstrated the benefits of giving patients access to their notes.

Here are seven things to know about OpenNotes.

1. The program was launched in 2010, with more than 100 physicians at three BIDMC-affiliated hospitals providing 20,000 patients electronic links to their physician notes.

2. Sigall Bell, MD, assistant professor of medicine at Harvard Medical School and lead author of the study, told The Boston Globe OpenNotes isn't a software or tool; rather, it is a "philosophy and commitment to transparency."

3. After five years, patient responses to the program were generally positive, with many patients feeling more in control of their health and being better prepared for appointments.

4. According to the OpenNotes website, more than 60 percent of patients reported adhering to medication guidelines better because of OpenNotes. Additionally, 77 percent said they felt more in control of their care, 86 percent said having an open notes type of program would be a factor in choosing a physician or health plan and 99 percent of patients wanted OpenNotes to continue.

5. Additionally, clinicians reported little to no impact on their workflow. According to OpenNotes, less than 8 percent of physicians said it took extra time to address patient questions outside of visits, and less than 20 percent said OpenNotes required more time to write the notes.

6. Allowing patients access to clinicians' notes also has a positive impact on patient safety, as they can serve as a second set of eyes that can catch mistakes in the record. "In many common safety categories, it appears that having the patient's or an informal caregiver's eyes on clinical notes can help ensure care is safer. Doctors review hundreds or thousands of charts; patients review one: their own," Dr. Bell said in a statement.

7. However, physicians also expressed some concerns with the program, namely that some physicians may write notes more vaguely knowing patients were reading them. Also, there is a concern regarding if/how patients would define mistakes in the notes and report errors, which could impact patient-physician trust. "We understand that these are real concerns that need to be addressed with education, innovation and further research. But we think solutions can be reached," Dr. Bell said.

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