Open notes is a hit with physicians, study finds

It’s been four years since Congress passed the law-the 21^st Century Cures Act-requiring that patients have electronic access to their medical records, including doctors’ notes. And despite some initial skepticism about note sharing among doctors and other clinicians, a substantial majority in a recent study say they think note sharing is a good idea.

Researchers queried physicians, advanced practice nurses, physician assistants and therapists at three health systems in Boston, Seattle, and rural Pennsylvania. Among the 1,628 responders, 74 percent said they have a positive view of note sharing, or open notes. Of the 1,314 who knew that patients were reading their notes, 74 percent said open notes are a useful tool for improving patient engagement, and 61 percent said they would recommend note sharing to colleagues at other institutions.

In addition, 25 percent of responding clinicians said they encouraged patients to read their notes, and 18 percent said patients mentioned notes during visits at least once a month. Many respondents said that open notes has led them to change how they document patient visits. The change mentioned most often was use of language that patients might perceive as being critical. And 36 percent reported spending more time writing their notes because of note sharing.

Somewhat surprisingly, the survey found that 63 percent of respondents who were licensed before 2000 would recommend open notes to colleagues at other institutions, compared with only 55 percent of those licensed after 2000. The authors speculate this may be due to older doctors having longer-established relationships with patients, a greater appreciation of the importance of communication, and more confidence in their communication and note-writing skills than their younger colleagues.