$10 Million in Grants to Promote OpenNotes and Study Impact on Patient Engagement

$10 Million in Grants to Promote OpenNotes and Study Impact on Patient Engagement

More than ten million patients now have online access to the notes and care plans written by their doctors during a visit. What started as a small, physician-led experiment in 2010 aptly called “OpenNotes” has blossomed to more than 50 health systems providing access via patient portals to doctors’ notes alongside test results, self-management tools, etc.

As approaches to care change to support value-based payments, the importance of patients who are actively engaged in their health and healthcare is now widely recognized. Active involvement is especially true for individuals with chronic medical conditions. Patients who are more informed have higher quality communications with their care team and take a more active role in their healthcare. Hence, the growing interest in patients who read and understand the observations and recommendations made by their doctors.

The OpenNotes initiative, which started as a study involving a few dozen primary care providers, has shown that when notes are accessible online, clinicians more carefully document patient visits and care plans. Patients pay close attention to the notes, build trust with their providers, and tend to follow instructions better.

To date, concerns about letting patients read doctors’ notes have mostly been unrealized. At the onset of an OpenNotes implementation, clinicians may anticipate large volumes of patient questions about the notes, confusion or misinterpretation, or negative reactions from patients. Similar to the early days of secure patient-provider messaging, patients show thoughtfulness and restraint, and these concerns become non-issues.

Like all promising emerging health information technologies, more research is needed before OpenNotes is widely accepted by doctors and becomes a standard feature of the healthcare system. Here’s a partial list:

  • Only 10%-15% of patients granted access to OpenNotes actually take advantage – Why isn’t this rate higher?
  • What “best practices” are emerging in the field to optimize the use of OpenNotes by clinicians and their patients (e.g., sending email reminders to patients notifying them that notes are available)?
  • Do patients who regularly consume OpenNotes show better health outcomes?  

In late 2015, the OpenNotes organization received $10 million in grants over three years to advance the study and adoption of OpenNotes efforts across the country. The life cycle of OpenNotes is a classic example of how to nurture an innovation in an industry that historically is slow to adopt new information technologies. In a nutshell, run studies in parallel with efforts to spur adoption and use the results from the research as a catalyst to generate more funding and further diffusion.

Like OpenNotes seven years ago, innovations with promise abound. What’s needed are more scholar-practitioners who can procure the funding and conduct the research in the field to shine a light on those technologies that demonstrate tangible benefits and can make a difference in patients’ lives. Is there an opportunity percolating in one of your professional communities?