OpenNotes opens doors for patient engagement

On November 4, Group Health launched OpenNotes at its 25 medical centers—giving all patients who use MyGroupHealth ready access to the notes their providers write after an in-person visit. The federal Health Insurance Portability and Accountability Act (HIPAA) already grants patients the right to review their entire medical record—including providers’ notes. But with OpenNotes, the power to do so is now at patients’ fingertips.

“Group Health's philosophy has always been that the patient's medical record belongs to them,” explained Steve Tarnoff, MD, and Mark Szalwinski, MHA, who lead the organization’s Group Practice Division. “As we work to provide a superior patient experience, using OpenNotes honors what patients need and want.”

The move is also consistent with national and regional trends toward increased transparency in health care, with organizations like the Veterans Affairs, the University of Washington, Mayo Clinic, and Virginia Mason having already adopted OpenNotes. Leading the rollout at Group Health are: Group Health Vice President of Informatics and Chief Medical Informatics Officer Gwen O’Keefe, MD, FACP; Medical Director for Quality Matt Handley, MD; and Medical Director of Clinical Informatics Fred Brodsky, MD—all of whom are clinical associates at Group Health Research Institute (GHRI).

OpenNotes is gaining momentum due in part to promising research from a team of investigators that included GHRI Associate Investigator James Ralston, MD, MPH. In 2012, their team studied 100 volunteer primary care providers and more than 13,000 patients who used OpenNotes for one year at Harborview Medical Center, Geisinger Health System, and Beth Israel Deaconess Medical Center. Among their findings: patients felt more in control of their care and were more likely to take their medications as prescribed—while providers reported very little, if any, added burden.

Thanks to a Partnership for Innovation grant from the Group Health Foundation and additional funding from the Robert Wood Johnson Foundation, Group Health will continue to learn about the impact and potential of OpenNotes. Dr. Ralston and GHRI Associate Investigator Robert Penfold, PhD, are leading an evaluation that will look for benefits and negative consequences for both patients and providers.

“Although we have encouraging results from studies among volunteer primary care physicians and their patients, we need to better understand the impact of OpenNotes as it spreads across primary and specialty care in settings in the United States,” Dr. Ralston explained. “Our research at Group Health provides a unique opportunity to inform the wider use of OpenNotes.”

“It’s also an important opportunity to learn whether empowering members with more information about their care can help increase their participation in decision making and ultimately improve their overall health,” Dr. Penfold added.