My prediction for 2014 is that it’ll be a blockbuster year for OpenNotes – sharing clinical notes with patients online.
For providers who want that level of transparency, yet find physician attitudes can be a roadblock – take heart. We can move the needle and change minds. I observed this during Medicine Grand Rounds at Oregon Health & Science University (OHSU).
Tom Yackel, MD, MPH, OHSU’s Chief Medical Information Officer invited me to join him to give a talk on OpenNotes. It was a easy ask; I’m a huge champion of the Veterans Health Administration’s Blue Button offering OpenNotes, now one year and counting. Sharing notes is also an area of my research, particularly from the perspective of patients and caregivers.
Grand Rounds was just before the holidays, so I worried about attendance. Turns out it was well attended. Maybe the topic raised curiosity. We gave out audience response gadgets to poll attendees at the beginning and end of the talk. Early on, we asked people their agreement with the question, “I think sharing progress notes with patients in MyChart is a good idea”. Purposely not displaying results the first time, we asked again after the presentation & discussion. The proportion who agreed sharing notes was a good idea increased from 54% to 80%.
It’s hard to know if the patient experience stories hit home, or maybe people were leaning to support OpenNotes in the first place. Perhaps a crucial moment happened when the discussion focused on provider workload and a physician leader said:
“We’ve been doing this for 10 years at the VA, and I’ve never had any problems from a patient being able to read their notes. We need to get over this and move on.”
Here’s our results — Before and After Grand Rounds:
When it comes to OpenNotes, engagement with Patients starts by Engaging with Providers. Yes! We Can!
Link to Grand Rounds video is here.
Here are the slides we presented:
