For the past several months I have had the privilege to work with patients, families and care providers at the University of Minnesota Medical Center where we embarked on piloting OpenNotes. Acknowledging that we were likely the first hospital to attempt giving patients and families access to their medical notes throughout their stay, we employed both quantitative and qualitative approaches to gauge how increasing access would impact the MICU and MED-SURG services.
The results were similar to the OpenNotes studies that took place in the outpatient setting at organizations like Beth Israel Deaconess. After being exposed to at least three days of being delivered medical progress notes, patients and families at the University of Minnesota Medical Center felt the notes allowed them to understand their care better (85%) and this was done with little to no disruption to provider workflow (in fact, 28% of providers actually felt delivering these notes made care more efficient).
Yet, despite the reality that patients have a right to this information today in time and despite how well this pilot was received by the patients and families enrolled in this project, this proactive approach seems far from becoming the norm in our industry. There is simply too much fear that granting access will cause harm to patients and families. As described in the article, Benefits from Destroying the Black Box (or Are We Opening Pandora’s Box?),  the idea of giving patients and families more access to their own information is frequently met with a long list of concerns from clinicians and administrators alike. But these concerns are often unwarranted, and several studies have shown that giving patients access to the physicians notes can actually increase medication compliancy and patient satisfaction.
As the healthcare industry continues to struggle with doing more with less, it seems logical that we should embrace solutions that empower patients and families to get more involved with their care. Not only is this a cost-effective method of lessening the burden on our care providers, it is a concept that many patients fully support and yearn for. What remains unclear, however, is who will own this massive transformation.
For more information regarding OpenNotes, visit: http://www.myopennotes.org/
 Delbanco T & Walker J. Benefits from Destroying the Black Box (or Are We Opening Pandora’s Box?) SGIM Forum 35(2):1-2 (2012). Accessed at http://www.sgim.org/File%20Library/SGIM/Resource%20Library/Forum/2012/Feb2012-02.pdf.