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Home / News & IndustryManaged Care Insight and Analysis
Updated: April 6, 2010
Researchers Touting An Open Book Approach Between Doctor, Patient

Is physician note sharing with their patients a way to improve care or a surefire way to lead to misunderstanding?

A year-long, $1.4 million grant from the Robert Wood Johnson Foundation is aimed at helping researchers determine just that. Researchers will assess the benefits of increased medical transparency to determine if it would increase patient-physician trust and communication and better engage patients in managing their own care. Patients already have the legal right to see their records, including doctors’ notes, but it’s a long, slow process.

Called the OpenNotes Project, approximately 100 primary care doctors and 25,000 patients will evaluate the impact on patients when physicians share their comments and observations after each patient encounter.

The participants are Boston’s Beth Israel Deaconess Medical Center, as well as primary care physicians and patients at Geisinger Health System, Danville, Pa. and Harborview Medical Center, Seattle.

Conceding that doctors have strong differences of opinion about the idea, Stephen Downs, an assistant vice president at RWJF, said this could lead to "a subtle change" in the doctor-patient relationship and "could reposition notes to be for the patient instead of about the patient, which … in the long run, lead to better care."

Reporting in the Journal of General Internal Medicine, Harvard Medical School’s Dr. Tom Delbanco and Harvard Medical School’s Jan Walker, RN, found that consumers want full access to all of their medical records and are willing to make some privacy concessions in the interest of making their medical records completely transparent.

Dr. Jonathan Darer, Geisinger’s lead investigator on the project, said some doctors are "worried that the notes could be misinterpreted and create more communication issues than they solve."

Still others believe that if patients were able to access their notes it could serve as a reminder to follow their doctors’ healthcare recommendations.

For more information on the OpenNotes Project, visit

  This article was taken from:
Pay-For-Performance Reporter

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