Beth Israel Deaconess Medical Center is launching a pilot that gives patients unprecedented input to their electronic health records.

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

Thanks to a $450,000 grant from The Commonwealth Fund, BIDMC will be one of the health systems to introduce OurNotes, the latest step in the evolution of the OpenNotes movement, which gives patients easy, online access to their doctors' jottings. This new engagement initiative will enable patients to write directly into their own EHRs.

"We believe that OurNotes, which will enable patients to contribute to their own medical records, has the potential to further enhance communication and engage patients in managing illness more effectively and efficiently, leading to improved patient safety and quality of care and potentially, to lower healthcare costs," said Jan Walker, RN, a member of the research faculty of BIDMC's division of general medicine and a co-director of the OpenNotes project, in a press statement.

[See also: Power to the people! Engaging patients]

On Feb. 10, at the Healthcare IT News/HIMSS Media Patient Engagement Summit, at the Hyatt Regency in Orlando, Walker’s BIDMC colleague, National OpenNotes Program Director Melissa Anselmo, will talk about why OpenNotes is such a hit with patients – and, despite some initial resistance, most of the physicians who participate too.

"We envision the potential capability of OurNotes to range from allowing patients to, for example, add a list of topics or questions they'd like to cover during an upcoming visit, creating efficiency in that visit, to inviting patient to review and sign off on notes after a visit as way to ensure that patients and clinicians are on the same page," said Walker.

The Commonwealth Fund grant will support work at five sites: original OpenNotes study partners BIDMC, Pennsylvania's Geisinger Health System and Seattle's Harborview Medical Center, in addition to more recent members Group Health Cooperative, also in Seattle, and Mosaic Life Care in St. Joseph, Mo.

"We know that increasing patient engagement is a critical component of improving health care, and we hope to build on BIDMC's well-established work in this area," said Anne-Marie Audet, MD, Vice President at The Commonwealth Fund. "This research will explore the potential for OurNotes to help improve care among the most medically complex patients-those with multiple chronic health conditions."

At BIDMC, a multi-center team will work clinicians, patients and others on a user-centered design process, focusing initially on primary care.

"During this phase we'll be asking clinicians questions about what kinds of information they think would be helpful to receive from patients," said Walker. "Likewise, we'll be talking to patients to find out what kinds of information they would like to contribute to their records and their notes."

Findings from that phase will be used to develop prototypes at each site and to conduct pilot testing that will pave the way toward formal clinical trials.

"We envision OurNotes as a therapeutic intervention that will prove effective over time for a wide range of patients, especially those struggling with chronic health concerns," said Jonathan Darer, MD, chief innovation officer at Geisinger Health System, in a statement.

"We expect this process to enlighten our understanding of patient and family engagement and its role in reducing healthcare costs, increased shared accountability, improving the health of those with chronic illness and multiple comorbidities and, most importantly, enhancing the overall patient experience of care," he added.

Patient advocates are already welcoming this news. 


"I’m beyond thrilled," wrote engagement guru 'e-Patient Dave' deBronkart on his blog. "Way beyond thrilled. This is going to take some figuring out, but is this what we've been striving toward, or what??"