Review of OpenNotes practice suggests improved safety, quality of care

The OpenNotes study, in which more than 100 primary care physicians granted 20,000 patients access to their own notes through a secure website, began in 2010. This practice is going a long way to improving safety and quality of care, according to an article published in the The Joint Commission Journal on Quality and Patient Safety.

"What we heard from patients and doctors fell into recognizable categories — for example, catching medication errors, better remembering next steps and improved plan adherence, enhanced error reporting, improved coordination of care for informal caregivers of vulnerable patients with many providers and appointments, and reduced diagnostic delay. 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." Sigall Bell, MD, lead author of the article, said in a statement. "OpenNotes may have a unique role in connecting patients and clinicians in the space between visits."

Clinicians report little to no impact in their workflow using OpenNotes and the number of patients who are able to read their notes has grown to more than 5 million in the U.S. Patients report improved medication adherence and engagement, and in some instances caught mistakes or inconsistencies on the part of their physicians.

Dr. Bell and colleagues are implementing this preliminary research in a two-year OpenNotes Patient Safety Initiative study, which will examine the impact of note sharing on medical errors, communication and safety with the goal of further developing an online feedback reporting tool for patients.

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