New OpenNotes data suggests that access to clinician notes helps patients understand their treatments, supporting medication adherence.
Advocates can add improved medication adherence to the list of benefits associated with patient data access and the OpenNotes philosophy, as a new study published in the Annals of Internal Medicine suggests a connection between the two.
The study, published by leaders from OpenNotes, surveyed 20,000 patients at early OpenNotes facilities about the impact access to clinician notes has had on their healthcare.
Patient respondents hailed from Beth Israel Deaconess Medical Center, the University of Washington Medicine, and Geisinger Health System, and revealed that OpenNotes have helped them become more engaged in and adherent to their treatment plans.
“Sharing clinical notes with patients is a relatively low-cost, low-touch intervention,” said Catherine DesRoches, DrPH, executive director of OpenNotes.
“While note sharing requires a culture shift in medicine, it is not technically difficult with most Electronic Health Record Systems, and could have an enormous payoff, given that we know poor adherence to medications costs the health care system about $300 billion per year,” added DesRoches, who works in the Division of General Medicine at BIDMC and an Associate Professor of Medicine at Harvard Medical School. “Anything that we can do to improve adherence to medications has significant value.”
Access to clinician notes helped 64 percent of patient respondents better understand why their clinician prescribed a certain medication, and another 62 percent feel more in control of their medications. Fifty-seven percent of respondents said they were able to find answers to questions they had about their medications, saving them a call to their doctors.
Sixty-one percent of respondents said access to clinician notes made them feel more comfortable taking their medications, while other patients said access to clinician notes improved their ability to adhere to medication plans.
Specifically, 14 percent of patients at BIDMC and Geisinger said OpenNotes improved their medication adherence. Thirty-three percent of UW patients reported medication adherence improvements.
The study showed even more pronounced improvements among patients who do not primarily speak English or who have lower health literacy scores.
Adding improved medication adherence to the list of the patient-centered benefits of data access should help providers overcome any reticence they feel toward the practice, said Tom Delbanco, MD, MACP, the study co-author and OpenNotes co-founder.
“This kind of transparent communication presents a big change in long-standing practice, and it’s not easy,” Delbanco, who is also the John F. Keane & Family Professor of Medicine at Harvard Medical School and BIDMC, stated.
“Doctors contemplating it for the first time are nervous,” he added. “They worry about many things, including potential effects on their workflow, and scaring their patients. But once they start, we know of few doctors who decide to stop, and patients overwhelmingly love it. The promise it holds for medication adherence is enormous, and we are really excited by these findings.”
Other industry leaders gave a nod to OpenNotes for representing a path forward for patient engagement and data access. As patient data access becomes a mainstay in healthcare, it will be essential to understand the best uses for data access, said David Blumenthal, MD, and Melinda K. Abrams, MS, both of the Commonwealth Fund.
“Transparency is no longer the distant, radical vision it was when the pioneering OpenNotes team began their work,” the pair wrote. “Rather, it is a fact of clinical life, mandated by federal law and policy…Our challenge now is to make the best and most of shared health care information as a tool for clinical management and health improvement.”
The healthcare industry has long recognized the benefits of OpenNotes and patient data access, stating that patients who view their own medical information and clinician notes will know more about their health and become more empowered in care.
Now, OpenNotes has uncovered its other benefits such as improving medication adherence and driving health equity.
A separate OpenNotes study published earlier this month in the Journal of Medical Internet Research revealed that the program can have a specific impact on vulnerable patient populations.
“Vulnerable patients may come to a visit with a lower baseline sense of control and knowledge than others; they may also have more difficulty understanding or retaining what practitioners say or emphasize,” the OpenNotes researchers wrote in their report. “Assisted at times by family members or other acquaintances who can help interpret and research points made in notes, the possibility of review in their homes may contribute to their particular enthusiasm for this new opportunity.”
Date: June 03, 2019
Source: Patient Engagement HIT