Once they start sharing notes with patients, docs don't want to stop

Tom Delbanco | Government Health IT | November 5, 2013

...the practice of sharing physician notes is mired in conjecture about elongated visit times, numerous questions outside normal encounters, curtailed productivity, and the concern that doing so will either offend or unnecessarily worry patients. Perceived factors that a new study has determined to be largely illegitimate.Perhaps the most telling statistics of all: Not one of the 105 primary care doctors elected to stop providing access to notes after the experimental period ended, and 99 percent of the 13,564 patients wanted to keep with the program of seeing their notes long past when the pilot was over.

“We have hit a national nerve,” says Tom Delbanco, MD, a primary care doctor at Beth Israel Deaconess Medical Center (BIDMC) in Boston and a professor at Harvard Medical School. “I’ve only wanted to do this for about 30 years. It’s simple to invite them into the doctor’s black box and (let them) see what we write about.”

...Recently the entire Veterans Health Administration has signed on with OpenNotes, which is an initiative, not a software program, Delbanco explained. Others to sign on include the Mayo Clinic, MD Anderson Cancer Center, Group Health, and Cleveland Clinic. The number of patients participating has reached more than 1.3 million, according to Delbanco.Historically, many doctors have been hesitant to share their notes with patients, but doctors participating in the OpenNotes trial at BIDMC, including Geisinger Health System in Danville, Pa. and Harborview Medical Center in Seattle reported that most of their fears about an additional time burden and offending or worrying patients did not materialize. To the contrary, many even reported enhanced trust, transparency, and communication with their patients.