Nine northwest health systems agree to make patient access to physician notes easier

By Jonah Comstock

elderly lady at computer opennotesNine health systems and organizations in Washington and Oregon -- representing more than a million patients -- have pledged to open up physician notes to patients via electronic medical records by the end of 2015. That increases the total number of patients with access to their physicians' notes by 50 percent -- from 2 million to 3 million altogether.

OpenNotes, the initiative that grew out of a successful Robert Wood Johnson Foundation trial in 2012 (still sponsored through an RWJF grant), worked with local nonprofit We Can Do Better to convince the nine organizations to adopt open notes. Those hospitals include Kaiser Permanente Northwest, Legacy Health, Oregon Health & Science University, Providence Medical Group Oregon, The Portland Clinic, The Vancouver Clinic, Portland VA Medical Center, OCHIN and Salem Health.

“Oregon and Southwest Washington represent the first region in the U.S. to collaborate on implementing open notes as a community,” Amy Fellows, Director of We Can Do Better, said in a statement. “Local health providers have been very supportive of providing patients here in the Northwest with this increased level of transparency. We look forward to the day when all consumers will be able to access their providers’ notes.” 

Patients have guaranteed access to their health records, including physicians' notes, under HIPAA. But getting that access is often complicated and time consuming. OpenNotes encourages hospitals to make that information available through a hospitals' patient portal, allowing patients to easily access it online. In the initial 2012 trial, conducted at Beth Israel Deaconess Medical Center (BIDMC) in Massachusetts, Geisinger Health System (GHS) in Pennsylvania, and Harborview Medical Center (HMC) in Washington, open records improved patient adherence. Perhaps more notably, physician fears that open notes would worry patients or increase their workload appeared to be unfounded.

All three original study sites have now adopted Open Notes as a standard practice, as has the Portland VA Medical Center, the Mayo Clinic and Cleveland Clinic. Chanin Wendling, Director of eHealth at Geisinger Health System, talked about their OpenNotes initiative at HIMSS earlier this year.

“If I want to make my clinical teams crazy, I try to add additional data into the portal,” she said at the time. “I usually get ‘Chanin, the patient won’t understand that’ or ‘The patient’s just going to call us, it’s going to create more work.’ That’s all bunk. … This past May, we made a decision to display Open Notes, the provider’s process notes. … We have about 1,400 providers displaying their notes to patients now. In our March 10th release I’ll have over 85 percent of the outpatient providers on board. I have not gotten a single complaint. Not a single comment from a patient or provider that says ‘You’ve ruined my life’.”