10.01.12 — In an editorial in the Annals of Internal Medicine, Matthews Distinguished University Professor Michael Meltsner expresses "A Patient's View of OpenNotes," a study that seeks to improve doctor-patient communication by letting patients know everything their doctor has to say about them, including after a visit. Meltsner's editorial has been widely quoted in the national press.

"As we enter the age of electronic medical records, with access to patient information almost a civil right, it is good to remember that communication patterns change in ways that reflect different community expectations and values," writes Meltsner, who recounts how opennes from doctors in regard to his own medical condition confirmed his belief that transparency is essential. 

The study, published online in the Annals of Internal Medicine, is the culmination of an experiment known as OpenNotes. Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle took part in the trial, which included 105 primary-care doctors and 13,564 of their patients who had at least one note available to them during the voluntary program.

While patients legally have the right to see their entire medical record, including doctor's notes, the notes aren't automatically included in requests for records and doctors don't make it easy for patients to see them, says Tom Delbanco, a primary-care doctor at Beth Israel who is co-lead author of the study and a professor at Harvard Medical School. Some doctors were initially resistant to the idea of sharing notes, he says. According to the study, doctors who declined to participate expressed concerns that their workflow might be disrupted and that they might scare or offend patients.

But the study, based on surveys of doctors and patients taken in fall 2011 after 12 to 19 months of participation, found most fears weren't realized, and patients were enthusiastic about accessing the notes.

"Opening complicated systems to greater client participation always includes dislocation. Here the benefits that come from a greater flow of information hold considerable promise for creating a healthier society, a result that is plainly worth the costs," writes Meltsner.

Media Coverage includes:

The Wall Street Journal: Access to Doctors' Notes Aids Patients' Treatment 
CNN: Study: Doctors should share notes with you
CBC News: Patients gain when doctors' notes open
Reuters: Patients like reading their doctors' notes: study
HealthDay: Sharing Notes with Patients Empowers Them: Study
Boston Globe: Beth Israel Deaconess study: Letting patients read doctors’ visit notes has positive impact
Modern Healthcare: Patients report better Rx adherence when docs share notes study
TedEytan.com: Now Reading: OpenNotes results are HERE – “little impact on doctors, 99% of patients recommended continuation”
The Healthcare Blog (Steve Downs): OpenNotes: The Results Are In
E-Patients.net: OpenNotes: The results are in. GREAT news for patient engagement
Consumer Reports: Patient access to their doctor's notes leads to better care, study finds
news@Northeastern: 3Qs: Patients' access to doctors' notes