What can be gained from allowing patients access to the notes their clinicians write after their visits? Actually, quite a bit, say HMS researchers at Beth Israel Deaconess Medical Center, including improved treatment plan adherence and enhanced error reporting. The research, reported in the August issue of the Joint Commission Journal on Quality and Patient Safety, presents an analysis of five years of use of OpenNotes, an online tool that makes health care notes available to patients.
In 2010, Beth Israel Deaconess was one of the pilot sites for the OpenNotes tool. For that study, more than 100 primary care doctors at three hospitals invited nearly 20,000 patients to read their visit notes through a secure website. Patients reported feeling more in control of their health and being better prepared for their visits, while physicians reported little or no impact on their workload. Since 2010, the number of patients who have access to their visit notes has grown to more than five million nationwide.
For the current study, the researchers drew from five years of experience with OpenNotes as well as from data from a new survey and from focus groups to examine key areas of patient safety and quality of care that might be affected by more open communication between doctors and patients.
“Patients and doctors told us that the use of OpenNotes helped them in many ways, including catching medication errors, improved coordination of care for informal caregivers of vulnerable patients, and reduced diagnostic delay,” says lead author Sigall Bell ’97, an HMS assistant professor of medicine and a member of Beth Israel Deaconess’s Division of General Medicine and Primary Care. “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.”
She adds, “Doctors review hundreds or thousands of charts. Patients review one: their own.”
According to Bell, patients are interested in participating in their care, noting that “while the responsibility for patient safety still rests primarily with health care organizations, this research shows us what’s possible when we make space at the table for patients.”