OpenNotes study finds better outcomes, more engagement

By Brian Dolan
04:36 am

Brian Dolan, Editor, MobiHealthNews[Reminder: Be sure to join us today at 2PM Eastern for the Inevitable, Imminent Rise of Remote Patient Monitoring webinar featuring presentations by MobiHealthNews, Preventice, and The Mayo Clinic. If you are not one of the 800 who has registered so far, don't miss out and sign up right here -- it's free!]

The final results from a yearlong study of how patients and their primary care providers would fare if patients were given access to their physicians' notes are in: Patients with access to the notes were more engaged and saw better outcomes. The final results are available in this week's edition of Annals of Internal Medicine. What's more the study's authors note that physicians did not report any increase in their workload and some didn't even realize the program was taking place.

The OpenNotes trial, which was funded by the Robert Wood Johnson Foundation, included participation from more than 13,500 primary care patients who were given access to their physicians' notes via an online portal and electronic messaging. More than 100 physicians participated in the trial. Overall nearly 11,800 patients out of the 13,564 opened at least one note during the study, which took place at three healthcare facilities: Beth Israel Deaconess Medical Center (BIDMC) in Massachusetts, Geisinger Health System (GHS) in Pennsylvania, and Harborview Medical Center (HMC) in Washington. About 84 percent of participating patients at BIDMC opened at least one note, while 92 percent of patients at GHS did, and some 47 percent of those patients participating at HMC did.

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According to the study's authors, a vast majority of the participating patients said that they could more easily understand their medical issues, better remember their treatment plans, better prepare for future visits, and that they felt an increased sense of control.

The study's authors were also "excited to see that more than half of patients who received medications reported improved adherence, consistent with findings about general adherence from another open-records study", but noted that self-reports fall short of objective data around adherence.

As we reported at the end of last year, many physicians expected that giving patients access to their notes about them would worry them -- more than 50 percent of primary care providers who were set to participate in the OpenNotes study and a vast majority of nonparticipating PCPs expected that sharing visit notes would lead to greater worry among patients, while only about 14 percent of patients felt that way.

The overall positive outcomes from this study could help patients to work more closely with their own primary care providers -- even those who practice at facilities that did not participate in the OpenNotes study. As e-Patient Dave concludes in his must-read analysis of the OpenNotes results:

"Many American hospital executives are greatly concerned about the new era of 'accountable care,' in which their reimbursement will increasingly depend on how well patients do, and that of course is affected by how much patients do. From the looks of things, this study – and my personal experience in it – strongly support the idea that best patient performance is supported by bringing the patient in – letting us see the medical record," e-Patient Dave writes. "The evidence says it doesn’t ruin the doc’s life. In fact, it’ll be a business advantage: most patients said it’ll be a factor in which providers they’ll choose! That’s how much patients want it."

Read the full study results here.


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