Can OpenNotes make patients healthier?
"That's the million dollar question, isn't it?" Walker says. "We didn't try to do that in this study. And we will probably be looking at that going forward. …. But you know, when people say they understand things better, and they remember what to do, and they're taking their medications better. I just can't believe that people aren't better off with this."
Harborview Medical Center, the safety-net hospital, faces logistical and budgetary challenges before it can expand its use of OpenNotes, says Joann Elmore, MD, MPH, professor of medicine and adjunct professor of epidemiology at the University of Washington School of Medicine, whose dean and medical staff run Harborview for King County in Washington State.
The medical center's patient population differs dramatically from the other OpenNotes test sites, and includes substantial numbers of patients who are part of separate groups, including homeless, incarcerated, nonEnglish-speaking, immigrant, and those with psychiatric problems and major trauma, Elmore says. Some had never used a personal computer before. Even if patients don't own computers or are homeless, they are accessing computers at community libraries and at the hospital in its Patient Education Center.
In addition, since the 2010 trial concluded, Harborview replaced some of its older EHR systems with newer ones, and budget concerns have prevented integrating the OpenNotes tab into those newer records but Harborview is actively working on it, Elmore says. "I should say that Eileen Whalen, our executive director, is so impressed with this, as is the dean, and they want to see us move forward," she notes.
This article appears in the May issue of HealthLeaders magazine.