Thanks to the computerization of medical records, the illegible scrawl of your doctor is mostly a thing of the past. Soon to be gone, too, might be the misunderstandings some patients have after they leave the doctor’s office – thanks to an initiative called OpenNotes.
Pioneered in Wisconsin by the Columbia St. Mary’s health care system, OpenNotes allows patients round-the-clock access to important medical information. That includes doctors’ observations, diagnoses, prognoses, instructions, test results, prescriptions, next steps and email communications. Patients access their files through a secure, online patient portal and can share the password with family members.
Although health care systems are required by law to allow patients access to their records – and many Milwaukee-area health care organizations do provide online access for those records – OpenNotes goes one step further. Patients not only see a summary, but their entire clinical medical record, including notes from conversations, is accessible. “You, the patient, get to see what you told me and what I told you,” says Dr. Bruce McCarthy, an internist and president of Columbia St. Mary’s physician division. “It’s not a summary. It’s like being able to hit a replay button on your visit to the doctor.”
McCarthy became interested in OpenNotes as his own mother got older and more forgetful. Her doctor was a friend of his, so he could call and ask what was actually going on. “But you shouldn’t have to be someone special to have that kind of access,” he says.
OpenNotes was tested nationally by 105 primary care doctors and 19,000 patients at three sites across the country. A study of OpenNotes showed that 99 percent of patients were enthusiastic about using the program. Doctors – who mostly had concerns about increased note-taking – were enthusiastic, too, with only 5 percent indicating a significant impact on their workload.
McCarthy adds: “It does take a little more work to phrase notes in a way that won’t worry patients and that doesn’t come across as judgmental.” But, he says, “it’s worth it.”
Another enthusiastic supporter of OpenNotes is Dr. Mark Horneffer, an internist and chair of CSM’s department of medicine. “My patients who have tried OpenNotes say it makes them feel much more like a member of the team,” he says. “It gives them more of a voice in their decision making. And the more complicated their medical situation, the more they love this idea.”
Joyce Sauer, a retired technology coordinator who lives in Brookfield, is one of Horneffer’s patients who adores OpenNotes. “No matter your age, when you get home, you often don’t quite remember what was said,” says Sauer, 74. “I can look at all the medications I’m on, my test results, vaccinations – you name it. I even found an error in my history and asked them to correct it.”
Jamie deRuiter, 30, a fitness instructor and Alverno College nursing student, appreciates the convenience of setting up appointments and reviewing test results online. “I had blood work done last week, and I didn’t have to wait for the results to come in the mail,” she says. “I probably saw them before the doctor did.”
Sauer and deRuiter currently have no major health issues; they simply want to be more knowledgeable. Patients with more serious concerns, says 43-year-old Cheryl Halverson, find OpenNotes even more helpful. “I was totally caught off guard by my breast cancer diagnosis because I thought I was the picture of health,” says the Cedarburg market researcher. “Sitting in the doctor’s office is such an emotional experience. You try to stay focused, but you don’t comprehend everything being said.”
Halverson says OpenNotes has allowed her to continually review the notes until she’s completely satisfied. “I’m an information hound, so the more information I have, the greater my peace of mind.”