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BIDMC Expands Online Access to Clinician Notes

OpenNotes expansion allows better communications between patients, physicians

BOSTON – Online access to the notes doctors, nurses and other clinicians write is now available for all primary care, orthopedics and rehabilitation services patients at Beth Israel Deaconess Medical Center.

The medical center plans to have outpatient notes from all specialties available by the end of 2013 (with a majority of departments and divisions on board by November), reaching almost a quarter of a million patients. Inpatient notes are expected to become available in 2014.

“BIDMC is among the first medical centers in the country, and the first in Massachusetts, to invite patients to participate in this transparent approach to care,” said Mark Zeidel, MD, Chair of BIDMC’s Department of Medicine. “We are confident that it is the right thing to do. Why? Many of our primary care physicians and patients were among more than 100 volunteering PCPs and 20,000 patients who completed a one-year, multicenter trial of OpenNotes. Doctors involved saw benefits for their patients and little, if any, burden for themselves.”

“What we see increasingly is that engaged patients have better outcomes,” says Kevin Tabb, MD, BIDMC’s President and CEO. “The study results showed that OpenNotes is a way to engage patients, so I’m really proud that our institution is adopting it in a big way.”

Starting Aug. 12, after each appointment or discussion, patients will receive an email inviting them to read their visit notes on PatientSite, BIDMC’s secure patient website. Approximately 116,000 patients will have the opportunity to read their notes with this initial expansion.

Patients who took part in the 2010 OpenNotes study reported that reading these notes helped them better understand their health and medical conditions, take their medications as prescribed and feel more in control of their care.

“I think it definitely helps patients take more ownership of their care and be more engaged in what’s happening,” said Kim Ariyabuddhiphongs, MD, a primary care physician who participated in the study. “This is a clear step towards, ‘this is about you, this is what we’re doing, and this is why it’s important’ and it just brings the patient into that whole discussion just a little bit more.”

“I think a good healthcare system is constantly changing,” says Tabb. “We’re constantly listening and reacting to our patients and we’re constantly learning. We believe providing patients open access to their clinicians’ notes is one of the best ways we can respond to their desire to be actively engaged in their own care.”

The OpenNotes study was led by BIDMC researchers, Tom Delbanco, MD and Jan Walker, RN, MBA. The study involved primary care doctors and patients at BIDMC, Geisinger Health System in rural Pennsylvania and Harborview Medical Center, a safety net hospital in Seattle, WA. 

“For more than 25 years now, Jan and I have been interested in looking at ways to transform the doctor-patient relationship,” said Delbanco.

“We’re proud that BIDMC is leading the way in making OpenNotes available to all patients, and we’re elated that, nationally, we’re moving closer to this type of transparency becoming a standard of care,” added Walker.

“As Beth Israel Deaconess Medical Center begins its institutional rollout of OpenNotes, it's becoming clear that we've moved into a new phase of the diffusion of this innovation,” said Steve Downs, Project Officer at the Robert Wood Johnson Foundation, which is the primary funder of the OpenNotes initiative.

“As we move into the implementation phase at this and other institutions, the questions will shift from whether the idea is good to more practical inquiries around how well it fits certain specialties.”

RWJF has just committed an additional $2.1 million to Delbanco and Walker to support this next phase of OpenNotes. The new grant will focus on spreading the practice of sharing visit notes by helping organizations with adoption decisions and implementation planning; and learning from the implementations that are now taking place and sharing those lessons with potential adopters.

Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and currently ranks third in National Institutes of Health funding among independent hospitals nationwide.

BIDMC has a network of community partners that includes Beth Israel Deaconess Hospital-Milton, Beth Israel Deaconess Hospital-Needham, Anna Jaques Hospital, Cambridge Health Alliance, Lawrence General Hospital, Signature Health Care, Commonwealth Hematology-Oncology, Beth Israel Deaconess HealthCare, Community Care Alliance, and Atrius Health. BIDMC is also clinically affiliated with the Joslin Diabetes Center and Hebrew Senior Life and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.org.

Contact Information

Beth Israel Deaconess Medical Center
330 Brookline Avenue, Boston, MA 02215
Main Switchboard: 617-667-7000
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