Can Sharing Notes with Patients Lead to Better Outcomes?

Can patients benefit from having electronic access to their medical chart, including the notes made by their doctor? A new study led by primary care physician Tom Delbanco, M.D., and Jan Walker, R.N., M.B.A., both of Beth Israel Medical Deaconess Medical Center and Harvard Medical School, seeks to find out.

Delbanco and colleagues are launching OpenNotes, a project designed to examine the impact of adding a new layer of transparency to a traditionally one-sided element of the doctor-patient relationship—the notes that doctors record during and after patient visits. The researchers believe that “inviting patients to review these notes could improve understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes,” according to an article published in the Annals of Internal Medicine.

Over a 12-month period beginning this summer, Delbanco’s team will follow more than 100 primary care physicians and 25,000 of their patients, all of whom have access to personal medical records online. The project will take place in three medical settings: Beth Israel Deaconess Medical Center (Boston, MA), Geisinger Health System (Danville, PA) and Harborview Medical Center (Seattle, WA).

Patients and physicians participating in the program will be asked about the potential risks and benefits of open medical record access. While patients have the legal right to examine their medical records, it is rare for doctors and patients to use the record as a collaborative tool, said investigators.

The project is being made through a $1.4 million grant from the Robert Wood Johnson Foundation's Pioneer Portfolio.