UCHealth’s OpenNotes Journey: From a Few Docs to Enterprise-Wide Acceptance

Now, the health system has 350 clinics, seven hospitals and 21 EDs on board in an “opt-out” model

Although the OpenNotes initiative—designed to give patients access and ability to read visit notes online—has now reached 12 million patients in the U.S. alone, there have been challenges and pushback along the way, dating back to the beginning of the movement. In fact, says CT Lin, M.D., chief medical information officer (CMIO) at UCHealth, a 7-hospital, 400-clinic system in the Rocky Mountain region, the “original” OpenNotes was actually called “SPPARRO,” or “Systems Providing Patients Access to Records Online.”

CT Lin, MDAlthough Lin admits he is no fan of that acronym, he says SPARRO was a system that spurred patient engagement progress. The original pilot experience in 2001 at UCHealth specifically included 100 patients in one heart failure practice with its associated seven physicians. “And we had trouble in even getting those seven to sign up,” says Lin. At the time, Lin says that providing patients access to their notes online was a research interest of himself and one of his colleagues in internal medicine, and was also backed by the CIO of the hospital at the time “who had a real drive to be transparent.”

Lin asks, “Why is it that the medical record so opaque to the patient? Something like 0.5 percent of all patients actually request their records, because we make it so hard. You have to pay $25 or maybe [the record] is in some basement of a building downtown, and it takes a month for you to actually get that record.  No wonder most patients don’t take that action and go through the activation of requesting their records,” he says. He adds, “It has [historically] been the view of healthcare that notations made by physicians are for themselves or for other doctors. It’s too dangerous for the patients, clearly, to know anything beyond what pill to take. This paternalistic view has existed for a long time”...