Three million US patients can now see their medical records online

BMJ 2014; 348 doi: (Published 16 April 2014) Cite this as: BMJ 2014;348:g2802
  1. Krishna Chinthapalli
  1. 1Paris

Online access to doctors’ clinic notes has been expanded to include over three million patients in the United States, a leading expert has said.

Tom Delbanco, professor of primary care at Harvard Medical School and co-founder of the OpenNotes initiative for shared notes, announced the finding in a keynote speech at the International Forum on Quality & Safety in Healthcare in Paris on 10 April. “We have more than three million patients in the USA, and thousands of doctors, nurses, therapists, trainees, physician assistants, case managers, and other clinicians sharing notes,” he said.

The new figure comes after a regional collaboration of US healthcare organizations that agreed to make notes accessible to patients living in the states of Oregon and Washington on 8 April. Delbanco said, “One million people served by nine competitors are all going to get OpenNotes. There’s a consortium in Portland, Oregon, that had gotten together and decided they would all do it. It includes Kaiser Permanente, who invited 500 000 patients to read their notes online from now on. So this is a virus that is spreading fairly rapidly.”

In a press statement Amy Fellows, director of We Can Do Better, a campaign group for shared notes, commented, “Oregon and Southwest Washington represent the first region in the US to collaborate on implementing open notes as a community. Local health providers have been very supportive of providing patients here in the Northwest with this increased level of transparency. We look forward to the day when all consumers will be able to access their providers’ notes.”

OpenNotes was set up in 2010 in three pilot healthcare institutions to allow patients to use a secure internet portal view to their medical record after a clinic visit. A study after one year of the initiative was published in 2012.1 Delbanco summarized the findings: “Patients reported very important clinical benefits . . . 80% felt more in control of their care, 80% reported understanding their conditions better, 80% reported remembering the plan for their care better . . . and 70% said they were taking their medicines better.”

Delbanco predicted that the use of shared electronic records would now expand into mental health and other care settings. “It’s going to spread into our hospital this year and in many other institutions. It’s going to come into nursing homes, into recuperative facilities, and into the home,” he said.

He suggested that another future development would be records that patients were able to edit or contribute to. “The next iteration, I think, will be ‘OurNotes.’ Remember the problem oriented record: subjective, objective, assessment, and plan. ‘Subjective’ is what the patient experiences. Why shouldn’t he or she write that up, provide it, and think about it before they come to see [the doctor]?” asked Delbanco.


Cite this as: BMJ 2014;348:g2802


  • The International Forum on Quality & Safety in Healthcare is an annual conference that is co-sponsored by the BMJ.


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