Managed Care


Access to Notes Boosts Adherence

MANAGED CARE October 2012. © MediMedia USA
News & Commentary

Access to Notes Boosts Adherence

The secret to medication adherence might be found in doctors’ notes, if patients are given online access to those notes, says a study in which three health systems offer expanded transparency. Beth Israel Deaconess Medical Center in Massachusetts, Geisinger Health System in Pennsylvania, and Harborview Medical Center in Washington offered patients online access to notes taken by their primary care physicians. (The three had three different starting and ending points; the shortest lasted a year and the longest lasted 19 months.)

By law, patients are entitled to such access. In practice, they rarely ask and physicians rarely remind them. That should perhaps change, says “Inviting Patients to Read Their Doctors’ Notes: A Quasi-Experimental Study and Look Ahead,” published in the October 2 issue of the Annals of Internal Medicine.

In the study, patients “received e-mails when a doctor’s note was signed and posted to their portal, but whether to open the note was up to the patient.”

The study included 105 primary care physicians with 13,564 patients. Of 5,391 patients who opened at least one note and completed a post-intervention survey, “77 percent to 87 percent across the three sites reported that open notes helped them feel more in control of their care; 60 percent to 78 percent of those taking medications reported increased medication adherence....”

At the end of the study period, 99 percent of patients wanted access to notes to continue and not one doctor asked that the service be stopped. The study says that “a remarkable number [of patients] reported becoming more likely to take medications as prescribed. In contrast to the fears of many doctors, few patients reported being confused, worried, or offended by what they read.”


2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
6th Semi-Annual Diagnostic Coverage and Reimbursement Conference Boston December 4–5, 2014
Customer Analytics & Engagement in Health Insurance Chicago December 4–5, 2014
Pharmaceutical and Biotech Clinical Quality Assurance Conference Alexandria, VA December 4–5, 2014
9th Semi-Annual Medical Device Coverage and Reimbursement Conference San Diego December 5, 2014
8th Annual Medical Device Clinical Trials Conference Chicago December 8–9, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015