Well folks, here’s more information about Open Notes from a physician who led a city-wide initiative to get ALL the hospital systems to adopt Open Notes, nearly a decade ago, with resulting excellent patient engagement and satisfaction and improved outcomes. And then I’m also on the webinar, too! Seriously, Homer Chin MD, formerly of Kaiser Northwest, where they pioneered many aspects of Open Notes, was able to collaborate with competitor healthcare systems throughout Portland and take the entire city to Open Notes; one of the few community wide collaborations of the sort.
If you’ve not been paying attention to the growing Open Notes tsunami, well, in a nutshell, its the idea of patients viewing their doctor’s progress notes about them, online.
Listen to the HealthsystemCIO.com youtube channel recording of our 30 minute webinar:
We’ve been live on Open Notes in one form or another since our original research back in 2000, but we finally went system-wide in May 2016. None of the anticipated fears of the docs materialized in a significant way (fears of: too many phone calls, lawsuits from offended patients, volumes of complaints about pejorative terms). We found lots of benefits: patients more engaged in their care, patients more adherent to therapy, patients asking better questions (instead of “what’s my test result”, more like “I read about my results, and does it mean this or that?”).
However, not everything is straightforward; from a technology standpoint, remember to set Open Notes as “default on” with docs having to “opt out”. This will get your open notes release rate into the 95-99% range. If you allow docs to “opt in”, requiring a doc to press a button to allow a patient to view their notes, your release rates will be in the single digits. Just like Staples’ infamous EASY button, in informatics, we want to MAKE THE RIGHT THING EASY.
If any of you have not read Leading Change (maybe a blog post on this in the future), it is one of my all-time favorite and most useful books for CMIO’s. Creating a burning platform was one thing I never did well in the early days of our Patient Portal and transparency efforts. Turns out, our research and scientific data, without corroborating human stories, did not change minds and hearts. Who knew? The medical leadership at our health system did not agree to go along with this project, back in the early 2000’s.
This time (2016), I packaged Open Notes as part of our EHR system upgrade (hey, guys, turns out Epic version upgrade that’s coming on May 16, 2016 ONLY COMES WITH OPEN NOTES! Let me help you get ready for that!), obtained the leadership buy-in from our CMO’s, developed a thorough marketing plan, met in-person with key physician leaders (specifically, loud and opinionated physician leaders), enlisted patients from our Patient and Family Centered Care council, conducted a small Open Notes pilot project in 7 primary care clinics for 6 months, gathered good left-brain-appealing statistics and right-brain-appealing stories, and generally jumped in with both feet.
If you stay till the end, you might hear (an improved) rendition of Doc Prudence, my anthem to Open Notes on the ukulele.
From Twitter @CIOCHIME