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This issue of BMJ Quality & Safety features a paper by Bell et al1 that follows up on the original ‘Open Notes’ experiment with providing patients electronic access to their primary care providers' notes. In the first report,2 the intervention was well received by the patients and did not provoke the anticipated adverse impacts feared by physicians. The current paper explores the effect of Open Notes on trust within the doctor/patient relationship, again finding generally positive responses from patients and doctors. Most patients indicated that they accessed notes to better understand and learn more about their health; and reading notes either did not change their feelings or made them feel better about their doctors. Most physicians thought that patient satisfaction had improved.
The concept of Open Notes builds upon the increasingly prevalent practice of giving patients electronic access to at least some components of their medical records through the use of patient portals tethered to provider electronic health records (EHRs). These portals are a natural extension of the growth in EHR use across the USA driven in large part by the HITECH Act and the Center for Medicare and Medicaid's ‘meaningful use’ programme. But they also reflect our increasingly electronic lifestyle and our reliance on the internet for …
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