Patients With Access to Their Physicians’ Notes May Have a Better Sense of Control Over Their Health

Patients with access to their physicians’ notes may gain a better sense of control over their health care. (Image: lionvision/

Results from a pilot study suggest that patients who have online access to their physicians’ electronic notes may be more engaged and understanding of their health and become more reliable in taking medications as prescribed. The findings appear today in the Annals of Internal Medicine.

The study involved 105 primary care physicians who volunteered to give their patients online access to personal medical records for a 12-month period. The study was conducted in a major urban hospital in Boston, an integrated health system in rural Pennsylvania, and a county hospital in Seattle and involved physicians who participated in OpenNotes, a program primarily funded by the Robert Wood Johnson Foundation.

The researchers surveyed 5391 patients who opened at least 1 note. About 77% to 87% of these patients (across the 3 sites) said that having access to their physicians’ notes made them feel more in control of their care, and 60% to 78% of those taking medication reported they became more consistent in taking their medication as prescribed.

Historically, physicians have been reluctant to share their writings with patients for a variety of reasons, but concerns about doing so may be overblown. Only 1% to 8% of patients reported that the notes caused confusion, worry, or offense. Few physicians reported longer visits (0% to 5%) or spending more time addressing patients’ questions outside of visits (0% to 8%) because of note sharing. Most of the surveyed physicians said they did not need more time to write their notes (0% to 21%).

The researchers concluded that widespread adoption of open notes seems a worthy goal. Caroline Lubick Goldzweig, MD, MSHS, Veterans Affairs Greater Los Angeles Healthcare System, in an accompanying editorial, acknowledged that a revolution is occurring in health care documentation but cautioned that more data are needed before sharing notes with a patient becomes a standard of medical care. Goldzweig wanted to know whether note sharing with patients might change physician-to-physician communication, whether it might impair the ability of other physicians to manage patients appropriately, whether it might be most useful in certain patient populations, and whether it might have a significant effect on outcomes.

Categories: Adherence, Medical Informatics, Medical Practice, Patient-Physician Relationship, Primary Care/Family Medicine