Health systems get on board with open notes

Encouraged by the patient engagement spurred by giants such as Geisinger and the VA who've taken part, Kaiser Permanente Northwest and eight other health systems in the region have signed on to OpenNotes -- the first widespread adoption of the data sharing program.

Kaiser Permanente began making clinician notes available to its members across the Pacific Northwest earlier this week.
"Now, nearly 500,000 Kaiser Permanente members will, for the first time ever, be able to easily view the notes charted by their doctor during an office visit," said Michael McNamara, MD, chief medical information officer for Kaiser Permanente Northwest, in a press statement.
"We want patients to feel connected with their providers, and to have the type of tools that will enable them to be more engaged and in control of their care."
Another half-million patients in Oregon and Southwest Washington will gain electronic access to the notes thanks to the participation of Legacy Health, Oregon Health & Science University, Providence Medical Group Oregon, The Portland Clinic, The Vancouver Clinic, Portland VA Medical Center, OCHIN and Salem Health.
Each of these groups is already practicing open notes in some form, or intends to do so sometime in 2014 or 2015. Supported by the Robert Wood Johnson Foundation, OpenNotes first launched with a year-long pilot in which 105 physicians in Boston, Pennsylvania and Seattle shared their clinical notes with more than 19,000 patients.
The findings were encouraging: nearly all the patients were in favor of seeing their medical notes, and no doctors opted to stop sharing them once the study was over. "To have 82 percent of patients open their notes is astonishing," said Jonathan Darer, MD, chief innovation officer for the division of clinical innovation at Geisinger, one of the pilot participants, in a 2013 press release.
"It speaks volumes as to how important this information is to them." In 2013, the Department of Veterans Affairs signed on to the initiative, enabling more than one million former service members to download their medical information via the My HealtheVet Blue Button.
As Jan Oldenburg, principal at Jan Oldenburg Consulting and author of the HIMSS book Engage! Transforming Healthcare through Digital Patient Engagement, said recently, the VA's experience showed pretty quickly that "people seeing their notes correlated with being more up-to-date with their preventive care."  
Now the movement is finding a much broader acceptance. "Oregon and Southwest Washington represent the first region in the U.S. to collaborate on implementing open notes as a community," said Amy Fellows, director of We Can Do Better, a grassroots movement in Oregon aimed at improving the healthcare system locally and nationally.
"Local health providers have been very supportive of providing patients here in the Northwest with this increased level of transparency," she added. "We look forward to the day when all consumers will be able to access their providers' notes."
"I've found that open notes is a great way to engage patients in their care," said Tim Burdick, MD, OCHIN's chief medical informatics officer and a practicing family physician at OHSU Family Medicine, in a statement.
"When we flipped the switch nationwide for all OCHIN clinics to use open notes, I was pleased with how excited patients and providers were about this approach."