1. 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

2. 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

3. 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.

4. 21+ Million Patients Have Access to Notes

5. A big change in culture for
clinicians, patients and
families

6. 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

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

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

9. Thank you! Let’s discuss!
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@myopennotes