Four Hospitals Piloting OurNotes Initiative in 2018
Beginning in January, four academic hospitals—Beth Israel Deaconess Medical Center in Boston, University of Washington in Seattle, Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire and University of Colorado in Boulder—will begin piloting a new digital tool called OurNotes that enables patients to contribute to their clinical notes.
The OurNotes initiative aims to encourage patients and providers to jointly create clinical notes and care plans within a shared electronic health record. Funded by The Commonwealth Fund, OurNotes is an extension of the nationwide OpenNotes, a movement to offer patients ready, online access to their clinicians’ visit notes. Currently, more than 20 million patients across the country have electronic access and can read their clinicians’ notes.
The pilot interventions will focus on patients who are managing the challenges that accompany chronic illness.
Encouraging patients to help write and add notes to their personal medical charts — a task typically handled only by medical professionals — may help patients feel more involved with their own care and improve relationships with their doctors, according to a study published in the Annals of Internal Medicine.
In that research, doctors at UCLA Health and Beth Israel Deaconess Medical Center found that patients could benefit if they are invited to co-produce medical notes, through OurNotes, with their doctors, rather than merely reading them. The practice may also benefit doctors by reducing time spent on documentation, according to a UCLA press release on the study.
“If executed thoughtfully, OurNotes has the potential to reduce documentation demands on clinicians, while having both the patient and clinician focusing on what’s most important to the patient,” Dr. John Mafi, assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, and lead author of the study said in a statement.
To prepare for the pilots, according to the UCLA press release, researchers conducted in-depth telephone interviews with 29 health care experts. There were 11 primary care physicians, two specialist physicians, three nurse practitioners, four health information technology professionals, eight patient advocates and one policy expert. All were familiar with OpenNotes or were OpenNotes users.
“Participants overall believed that OurNotes could promote patient engagement, improve patient-centered care and patient-provider collaboration, and possibly take some of the documentation burden off busy providers. The consensus was that the most promising approach for OurNotes is to contact patients before an upcoming visit and ask them to review previous notes, provide an interval history, and list what they hope to address at the visit,” the press release about the initiative states.
“One can argue that reading a note is far less active than actually participating in producing a note. Transforming practice with OurNotes holds great promise for more active patient involvement,” Jan Walker, senior author, OpenNotes co-founder and assistant professor of medicine at Harvard Medical School, said in a statement. “We’ve had a warm reception from clinicians who want to give OurNotes a try. They are intrigued by the notion that an interval history and agenda provided by a patient is a way to streamline the visit and address the patient’s priorities more effectively.”
