OpenNotes Community Meeting April 5th, 2016 Update 4/5/16

Why is records access a safety issue? MAPS Extensive focus group work to identify solutions for safer transitions Patients under-engaged Assume “the system” has everything covered Rarely told they matter in the caregiving process Care providers end up under-informed Misdiagnoses, mistreatments, delayed treatments 4/5/16

Safety is Personal “Engaging Patients and families in improving health care safety means creating effective partnerships between those who provide care and those who receive it – at every level...” Why Engage Patients for safety? Extra set of eyes, Know their symptoms Highly invested Always “present” Provide insights about care and care processes

4/5/16

NPSF Recommendations “At its core, patient engagement is about the free flow of information to and from the patient” 4/5/16

IOM Report on Diagnostic Error Estimated that 5 percent of U.S. adults who seek outpatient care each year experience a diagnostic error. Postmortem examination research… has shown that diagnostic errors contribute to approximately 10 percent of patient deaths, and Medical record reviews suggest that they account for 6 to 17 percent of adverse events in hospitals. Recommendations Health care professionals and organizations should partner with patients and their families as diagnostic team members …To accomplish this, they should… Ensure patient access to electronic health records (EHRs), including clinical notes and diagnostic testing results, to facilitate patient engagement in the diagnostic process and patient review of health records for accuracy

MAPS goals for the day Learn more about how providing access to patient records can improve patient safety, Understand how OpenNotes can help provide this access, and Learn how we can work with patients, employers, providers and health systems in our community to prioritize patient access to records.

OpenNotes Update 35+ participants; Purchasers, Health System CMOs, CMIOs, patients, MAPS member orgs, MN eHealth Initiative Good media follow up – Star Tribune, NPR, TPT Purchaser call for implementation Safety research opportunities Need to move quickly from ACCESS Meaningful Engagement

Diagnostic Error in Medicine Community Dialogue

Convening the Community – Diagnostic Error Goal: To develop an informal coalition of Minnesota leaders and organizations interested in addressing misdiagnosis in medicine, through collaborative efforts building from the 2015 IOM report, "Diagnostic Error in Health Care.” Conveners: Minnesota Alliance for Patient Safety (MAPS), MMIC, and Stratis Health Invitees: Minnesota Medical Association Minnesota Hospital Association Minnesota Academy of Family Physicians University of Minnesota Medical School/ UMP Minnesota Department of Health Minnesota Board of Medical Practice Minnesota Board of Nursing Minnesota Health Action Group Jefferson Center Mayo Patient rep. Health Partners Blue Cross Blue Shield Care Providers Leading Age Assess level of interest and commitment among attendees, and discuss a range/continuum of possibilities from least to most intense

2 meetings held to date – January & March There was great energy and enthusiasm from attendees, representing a broad array of stakeholders in health care, to continue the conversation around a coordinated effort to address diagnostic error. Initial thoughts for action coalesced around: shared communication and awareness building strategy prioritization of one collaborative project to pursue - Reviewed IOM report recommendations to help prioritize ideas

A. High feasibility/ B. High feasibility/ Feasibility Low impact B. High feasibility/ High impact Feasibility C. Low feasibility/ Low impact D. Low feasibility/ High impact Impact

Synthesis This is an optimistic group – very few projects had any scores in the low feasibility/low impact (C) quadrant Two project areas emerge: Patient/family and provider education and engagement Role of technology and EHRs (use cases, EHR interfaces, health information exchange) Considering for future exploration: Awareness and Knowledge building Collaborative project perhaps around test result communication