More than 100,000 Geisinger Health System (GHS) patients will soon have access to their doctors’ notes for the first time through the secure MyGeisinger online patient portal.

Geisinger plans to expand the OpenNotes initiative— which encourages doctors, nurses, and other clinicians to share their notes with patients in May due to the initiative’s overwhelming success. The expansion will include more than 500 Geisinger physicians, encompassing all of primary care and general pediatrics, and selected physicians within pediatric subspecialties, dermatology, endocrinology, pulmonology, nephrology, rheumatology, cardiology, cardiothoracic surgery, vascular surgery, neurosurgery, and women’s health—including obstetrics and gynecology and gynecologic oncology.

“One of the great challenges in medicine is getting patients involved in their own care,” Jonathan Darer, M.D., CIO for the division of clinical innovation at GHS, and Geisinger’s lead investigator on the project, said in a statement. “It’s clear that providing patients access to their doctors’ notes can be a powerful tool in accomplishing that goal.”
 
Funded through a $1.4 million grant from the Robert Wood Johnson Foundation, the 12-month OpenNotes project brought together 105 primary care doctors and more than 19,000 of their patients to evaluate the impact on both patients and physicians of sharing doctors’ notes after each patient encounter. The study included 24 primary care physicians and 8,700 patients at Geisinger, and additional patients and physicians from BIDMC and Harborview Medical Center, Seattle, Wash.

Findings from this pilot published in the October 2012 Annals of Internal Medicine indicated that patients enthusiastically supported seeing their medical notes and no doctors said they wanted to opt out at the end of the study.

The study showed that patients read their notes and felt more engaged when they did so. Close to 11,200 patients—approximately 82 percent—opened at least one note contained in their electronic medical record (EMR). Of 5,391 patients who opened at least one note, 77 to 87 percent across the three sites reported that OpenNotes made them feel more in control of their care and helped them adhere to their medication regimens.

Only a few patients reported increased worry, confusion or offense due to seeing their doctors’ notes. Eighty-five percent of patients reported that having access to their doctors’ notes would influence their choice of providers in the future.

These findings were in contrast to the concerns voiced by nonparticipating physicians, who worried that giving patients easy access to doctors’ notes would result in additional work for them and could offend patients.