Open Notes Access Good For Patient Safety

By Katie Wike, contributing writer

The Open Notes initiative which allows patients to access their doctors’ notes in the EHR has the potential to increase safety and care quality.

According to a recent study conducted by researchers from Beth Israel Deaconess Medical Center (BIDMC), access to the Open Notes program helps patients engage and increases their 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,” said lead author Sigall Bell, MD, in the Division of General Medicine and Primary Care and Assistant Professor of Medicine at Harvard Medical School in an announcement. “OpenNotes may have a unique role in connecting patients and clinicians in the space between visits.”

Fierce Health IT reports patients reported feeling more in control of their health. They also said the notes helped them to remember to take their medicine and to follow up as prescribed during their visits. Perhaps most importantly, some found errors, which were then corrected.

“These are all examples of patients who used the notes to engage in their own health care and to play active roles in making their care better,” says Bell. “The message that we are getting from many patients is that they want to participate in their care. And 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.”

Doctors noticed little or no impact on their work flow. iHealth Beat xplains that they did however voice some concerns:

• how patients would define mistakes
• how patients would report errors
• how the process would affect patient-provider trust
• whether their notes would become vague knowing that patients would be reading them

“We understand that these are real concerns that need to be addressed with education, innovation, and further research,” says Bell. “But, we think solutions can be reached. Data suggest that transparent communication can enhance trust, and that activated patients have better experiences of care. The benefits of partnering with patients in this way are likely well worth the effort.”