Enhancing transparency between physicians and their patients by permitting patients to view notes made in their health records appears to have a positive affect on the patient-provider relationship. A survey of providers and patients using OpenNotes found both parties perceived the program as beneficial.
OpenNotes is a nationwide initiative encouraging clinicians to share clinical notes and visit summaries with their patients. The initiative was formally introduced in 2010. Researchers analyzed pre- and post-surveys from 99 physicians who participated in OpenNotes and post-surveys more than 4,500 patients who read at least one note.
Patients reported reading their notes out of curiosity and to be better informed. Approximately one-third of patients said they reviewed their notes to check for accuracy. Seven percent of patients reported contacting their physician's office regarding the note, 29 percent doing so because of a perceived error.
Sharing notes did not negatively affect how patients view their physicians: 62 percent felt the same about their physicians after being able to view their notes and 37 percent reported feeling better about their physicians. Patients who reported improved feelings regarding their physician after reading their notes tended to be older, non-white males with fair or poor self-reported health and less formal education.
The positive feedback from patients stands in contrast to what providers indicated expecting from sharing notes. In the pre-survey, 26 percent of surveyed physicians said they anticipated documentation errors in the notes, and 44 percent believed patients would disagree with the notes. However, after a year in the OpenNotes program, 53 percent of physicians said they believed patient satisfaction increased, and 51 percent believed patients trusted them more.
"Despite concerns about errors, offending language or defensive practice, transparent notes overall did not harm the patient-doctor relationship," the authors conclude. "Rather, doctors and patients perceived relational benefits."
Survey results were published in BMJ Quality & Safety.
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