OpenNotes in Oregon: An Opportunity for All John Santa, MD MPH Director Dissemination OpenNotes, Beth Israel Deaconess Medical Center Oregon Academy of Family Practice April 13, 2018

Would you recommend this intervention? On average, 7 out of 10 patients reported: feeling more in control of their care taking better care of themselves understanding their health and medical conditions more remembering the plan for their care preparing for visits more effectively “I am doing better with taking my medications as prescribed.” Delbanco et al, Ann Int Med, 2012

OpenNotes: The New Normal Started as a one year demonstration and evaluation project in 2010 Replicated in multiple organizations with similar results Focused initially on primary care doctors, but subsequent research yields similar findings for other disciplines, including mental health.

21+ Million Patients Have Access to Notes

A big change in culture for clinicians, patients and families

Typical Worries Documentation of note More time needed during and after visit Requests to change note More queries or messaging Increase in patient anxiety or confusion Will I offend my patients? ‘Just one more thing…’ Low value

Challenges…for clinicians Patients with mental illness Adolescents Abuse Lousy notes (e.g. cut and paste) Coding requirements Burnout

Challenges…for patients Finding the note... Literacy and culture Time Education: What do I do next?

Thank you! Let’s discuss! Contact: myopennotes@bidmc.harvard.edu Website: www.opennotes.org Find us on Twitter, Facebook, LinkedIn, and Instagram! @myopennotes