OpenNotes give you access to your health records through a secure online portal. This helps you better manage your health.
OpenNotes is based on research showing some big advantages and improvement in outcomes simply by opening up your notes so that all of your own medical record is visible to you.
Key points
OpenNotes include the notes your doctor has written about you and the results of any tests you have had.
This helps you remember what you and your doctor talk about when you visit them and means you can stay more in charge of your health.
You access your OpenNotes online through a patient portal, which is a secure website provided by your doctor so you can access your health information.
You can also use the online portal to make appointments and send messages to staff at your health centre.
These portals are secure, which means that your health information stays confidential to you and your health practitioners.
In January 2017, more than 297,000 New Zealanders were using patient portals, and they were offered in 445 practices.
Find out your doctor has a patient portal and is using OpenNotes yet.
If your doctor doesn’t have a patient portal and OpenNotes, ask them when they will be available to you.
What are the benefits of OpenNotes?
Studies show that most patients remember less than half of what they discuss with their medical professional. Seeing your doctor’s notes helps you remember what you discussed and what action points you agreed.
Having more information about your health care helps you to understand your health condition better and stay more in charge of managing your own health.
OpenNotes can make your care safer. You can make sure there are no mistakes in the notes and they can remind you when you need to have check-ups.
If you want to share your health information with someone who is helping look after you, OpenNotes makes this easy to do.
What can I do with OpenNotes?
As with a patient portal, you can:
request repeat prescriptions
book appointments
see your lab results
see your current diagnosis
see a list of your medical conditions
see a list of the medications you are on
see your immunisation and vaccination history
receive reminders and recalls from the practice team
send and receive secure messages to and from your doctor or a practice nurse.
What is different with OpenNotes is that you can see your doctor’s clinical notes as well as all of the above options.
Video explaining OpenNotes - how it started and why it's so beneficial
(International Forum on Quality and Safety in Healthcare, 2015)
Does your doctor have OpenNotes yet?
You can put in the name of the medical practice you attend and find out if they have an online patient portal through which to access your notes. If your medical practice isn’t listed, ask your doctor or practice team when will they provide OpenNotes.
“In many cases, I’m looking at multiple options and trying to find the best way to manage my health issues. Having OpenNotes and access to all my information has given me much more control of my healthcare.” — Eileen Hughes, patient
This page will be of most interest to clinicians (nurses, doctors, pharmacists, specialists etc.) or those seeking more detail.
OpenNotes
“The OpenNotes initiative began in 2010 as a year-long demonstration project, with 105 primary care physicians at three diverse U.S. health care centres inviting 20,000 patients to read visit notes online through patient portals. Findings from the study suggest that shared notes may improve communication, safety, and patient-doctor relationships, and may help patients become more actively involved with their health and health care. At the study’s conclusion, 99% of patients surveyed said they would like to continue using OpenNotes, and not a single doctor turned off their patients’ access to notes.”¹
This result occurred because of the multiple advantages to using OpenNotes, including strengthening your relationship with your patients and helping them better manage their own health.
Are OpenNotes effective?
Research has found, for example, that:
Roughly 75 per cent of patients reported better recall of care plans, better self-care, a clearer understanding of their conditions, and feeling more in control of their health care, and about two-thirds of patients taking medications reported improved adherence to their regimens.¹
25 per cent of patients who contact their doctor as a result of reading their notes report a possible error, so a second pair of eyes enhances patient safety.
Up to 78 per cent of patients reported that OpenNotes helped them take their medications as prescribed.
77–87 per cent of patients said that accessing their notes made them feel more in control of their health care, and
Fewer than 5 per cent of doctors using OpenNotes reported spending more time addressing patient’s questions outside of visits, and most reported not changing the way they wrote notes.²
Video series
A series of useful videos have been published on the OpenNotes website and cover a range of topics from 'Sharing notes with patients' and the benefits for mental health patients through to 'Will OpenNotes take more time."
2014 Paris keynote - Opening the Black Box: Inviting patients into the medical record - Dr Tom Delbanco
(International Forum on Quality and Safety in Healthcare channel, 2015)
Although rigorous economic analyses are not yet available, improved medication adherence, error prevention, enhanced patient trust and satisfaction, and a safety net for care partners of vulnerable patients are likely to translate into bottom-line value.¹
Before introducing a patient portal, general practices in New Zealand are required to complete a privacy impact assessment (PIA) template to evaluate the security they have in place to manage and store patients' clinical information. It has been developed by Compass Health and approved by the Office of the Privacy Commissioner – Shared care record – Privacy impact assessment Compass Health, 2010.
The Ministry of Health has information about the resource impacts of patient portals for general practices, the financial advantages and disadvantages of five financial models (no patient charge with substitution, no patient charge without substitution, no patient charge with clinical query increase, annual subscription fee or online transaction fee only) and a financial modelling tool here – Patient Portal Resources
"OpenNotes and sharing the notes made me do a better job and made me more efficient. I went home at the end of every day finished with all my notes.” — Peter Elias, MD
“I believe that making sweeping determinations to block records from patients suffering from behavioural health conditions amounts to treating them like second-class citizens.” — Carol Novak, MD, Psychiatrist
“Family members are among the most vigilant of health system stakeholders.” — Jennifer L. Wolff, PhD, Johns Hopkins Bloomberg School of Public Health
“One of the advantages of the note is that if the patient has doubts or questions, she may look back at the note and see. What is the plan, and what did we discuss?” — Arturo Diaz, MD, Rheumatology, Beth Israel Deaconess Medical Center
"As the OpenNotes movement spreads, it offers important opportunities to learn from many health care professionals and health systems, as well as millions of patients. By collaborating closely with researchers across the country and around the world to understand the effects of fully transparent medical care on communication, engagement, safety, costs, and the overall quality of care." (Sourced from: OpenNotes – Research)
Delbanco T, Walker J, Darer JD, Elmore JG, Feldman HJ, Leveille SG, Ralston JD, Ross SE, Vodicka E, Weber VD. Open notes: doctors and patients signing on Ann Intern Med. 2010 Jul 20;153(2):121-5.
Similar articles US National Library of Medicine, National Institutes of Health
OpenNotes video series
OpenNotes is working to make sharing visit notes with patients a routine part of care. Patients can check what was discussed and what's planned. This can provide a useful reminder and also enables the option to share this information with their families (if they choose).
Research shows that when patients have access to their doctors' notes, they feel more in control of their health care, better understand their medical issues and report they are more likely to take their medications as prescribed.
