VHA Joins 'OpenNotes' Effort for EHR & PHR Systems

The Veterans Health Administration (VHA) has joined the Robert Wood Johnson (RWJ) Foundation's 'OpenNotes' initiative as a partner along with other healthcare provider organizations – Beth Israel Deaconess Medical Center, Harborview Medical Center, Geisinger Health System, MD Anderson Cancer Center . These organizations are all fully committed to giving patients online access to clinical notes.

Funded by a $1.4 million grant from the Robert Wood Johnson Foundation, the OpenNotes initiative has created quite a stir in the world of health care reform since its inception back in 2009. OpenNotes is an initiative that encourages efforts to allow patients to review the clinical notes written in their medical records by their doctors, nurses, or other clinicians.

Go online and try to find OpenNotes open source software solution.  What you will find is no such open source software exists.  It appears OpenNotes is an idea, an organization, a project, an initiative…   It's not a specific free and open source software (FOSS) solution that you can download and start using, like OpenOffice or OpenEMR.  It's all about the concept of open data and sharing knowledge at a very personal level.

According to MyOpenNotes.Org, patients ought to have the right to read the notes their doctor or clinician writes about them during or after a clinical appointment.   Electronic medical records and secure patient portals have finally made this process feasible for many healthcare provider organizations and their patients.

Evidence to date from those using OpenNotes suggests that 'opening up' clinical visit notes to patients may make care more efficient, improve communication, and help patients become more actively involved with their health and the health care process.

The VA’s more than two million authenticated users of My HealtheVet personal health record (PHR) can now use Blue Button ‘Download My Data’ to view, download or print a health summary of their medical record along with all clinical notes, as well as laboratory, radiology, and medical test results. This includes specialist notes, mental health notes, emergency room notes, and hospital discharge notes.

Selected Case Studies

U.S. Department of Veterans Affairs (VA) – The VA is home to the United States’ largest integrated health care system, with over 1,700 sites of care serving 8.3 million Veterans each year. The VA is committed to transparency and patient-centered care by enhancing information and services available to Veterans online. The VA’s personal health record (PHR), called My HealtheVet, now boasts more than 2.2 million registered users.

In 2010, VA introduced the Blue Button, allowing Veterans to view, print, or save their personal health information.  Since January 2013, Veterans with a My HealtheVet 'Premium Account' have access to clinical notes that have been entered into the VA's electronic health record (EHR), known as the VistA System, that is used in all VA hospitals, clinics, and nursing homes across the country.

Using My HealtheVet and the Blue Button, as of 2013 patients treated at the VA now have access to 'OpenNotes' that include outpatient primary care and specialty visit clinical notes, discharge summaries, and notes from emergency department visits. In addition, patients also have access to a wide range of clinical test and imaging results.

University of Texas MD Anderson Cancer Center -  Patients and their referring physicians at the MD Anderson Cancer Center have been given access to their electronic medical records (EMR)—including their doctors’ notes—since May 2009 via a secure web-based portal.

As of 2012, more than 40,000 individuals have viewed their records over 605,000 times. In that same period, more than 1300 referring physicians accessed the records of the patients they referred to the center.  Currently, 84% of the center's active patients have obtained access to their electronic medical records.

Patients at the Cancer Center have become avid readers of their notes. Their two most common requests are for a correction of something recorded incorrectly and for a simple method of translating medical terminology within the record. Referring physicians are generally pleased with the OpenNotes tool, and the center is planning to cease mailing paper records to referring physicians.

For more information on on these case studies, read Who's Sharing Notes about the MD Anderson Cancer Center and the JMIR Journal article abou the VA.


Finally, as reported in the Annals of Internal Medicine in October 2012, the OpenNotes quasi-experimental trial funded by the Robert Wood Johnson (RWJ) Foundation, a vast majority of the 13,500 participating patients said that they could more easily understand their medical issues, better remember their treatment plans, better prepare for future visits, and that they felt an increased sense of control.

Check out  other related news articles & information about OpenNotes previously posted on Open Health News (OHN).