OpenNotes Expansion Lets Patients Make Notes On Their Records

The OpenNotes Project, hailed by health information management (HIM) and patient engagement advocates for opening patients’ records up to the patients, is expanding to become more interactive in a small pilot.

The first part of the OpenNotes Project allowed patients at designated medical centers have access to progress notes written by their primary care physicians. The planned expansion of the program—which will be piloted at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System, two hospitals in Seattle, and a hospital in St. Joseph, MO—will let selected psychiatric patients correspond with their physician about their records through a Google Docs-like platform.

“For clinicians, this can look like such a flood of data coming toward them that it’s impossible to pay attention to, to distill it and act on it, and be responsible for understanding everything that’s coming in,” Jan Walker, co-director of the OpenNotes project and a researcher at Beth Israel Deaconess and Harvard Medical School, told Boston Public Radio.  “So one of the interesting parts of this research is figuring out how to highlight important things for clinicians, and let the rest just be stored.”

The project is being funded by a new $450,000 grant from the Commonwealth Fund. Investigators aren’t certain what kind of application patients will use for “OurNotes” to add notes and comments to their record, but suggest it will be very similar to Google Docs, the Google product that allows multiple people to add notes and comments to working documents.

Investigators hope that patients will use OurNotes to set an agenda for upcoming appointments with their physician, point out errors in their record, ask their doctor questions about ongoing problems and treatments, or even help co-write a progress note during an appointment.

Some patients’ providers already have patient portals for communication with their care team, but researchers say patients in general are pretty cautious about e-mailing their physicians too often.

“OurNotes will complement that capability, by enabling patients to almost keep a diary for themselves, of things to remind themselves about that are not urgent,” Walker said. “Eventually, I think the lines between emailing the doctor and writing messages in the notes themselves may actually blur.”

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