OpenNotes, a national initiative to provide patients with access to their doctors' and clinicians' notes, has scored $10 million in new funding in total from Cambia Health Foundation, Gordon and Betty Moore Foundation, Peterson Center on Healthcare and the Robert Wood Johnson Foundation.

The grants are aimed to help spread the access to clinical notes to 50 million patients across the country.

Proponents of the OpenNotes initiative say this change in practice represents an aggressive step in the movement toward greater transparency in healthcare.

[See also: OpenNotes: 'This is not a software package, this is a movement'.]

The results of an OpenNotes experiment involving 100 primary care doctors and 20,000 of their patients were published three years ago in the Annals of Internal Medicine. Since then, the OpenNotes movement has spread to more than 5 million Americans.

The premise of OpenNotes is that ensuring access to notes written by doctors, nurses and other clinicians can prompt patients to be more active in their own health and healthcare, and greater patient engagement can contribute to better outcomes and reduced costs throughout the system.

By dramatically expanding the scope of the OpenNotes project, the four national philanthropies funding the program hope this innovation in the delivery of care, if spread nationwide, can improve the U.S. healthcare system's performance.

[See also: OpenNotes shows success with medication adherence.]

"Our research shows increasingly that patients can benefit greatly from reading the notes taken during a medical visit," Jan Walker, RN, co-founder of OpenNotes and assistant professor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, said in a press statement. "They tell us they feel more in control of their care and are more likely to follow up on recommendations.

"This has enormous implications for improving the quality and costs of care," she added. "Moreover, we're learning that having a second set of eyes on the record may be an important way to improve patient safety."

For the next three years, the new funding will support OpenNotes' ability to assist providers with adoption, to reach a wide range of consumers and to evaluate the impact of the effort on health outcomes and costs. OpenNotes will work with an advisory board to target healthcare organizations and consumer advocacy groups, and also individual clinicians and consumers.

[See also: OpenNotes showing benefits at BIDMC.]

Based at Harvard Medical School and BIDMC and initially funded primarily by the Robert Wood Johnson Foundation, OpenNotes began in 2010 with a research and evaluation study examining the impact of offering clinician notes to patients at BIDMC, Harborview Medical Center and Geisinger Health System.

At the end of a year, those who read their notes reported feeling more in control of their care and having better recall, knowledge and understanding of their medical conditions. Ninety-nine percent of patients wanted the practice to continue, and all participating doctors chose to keep their notes open after the study ended.

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