Funding Area: Empowering Health Care Consumers

Shared visit notes, often referred to as open notes, are an important way to help consumers become active participants in their own care.

When patients have access to their own visit notes written by health care providers, they better remember and act on information discussed during visits, improve communication with their health care team, and better manage their health. The 21st Century Cures Act, a recent federal mandate, requires health care providers to make clinical notes available to patients electronically and at no charge. However, the level of compliance and, most importantly, the proactive use of open notes to improve care vary among health systems. In 2022, NYHealth issued a Request for Proposals (RFP), “From Good to Great: Improving Access to and Use of Patient Visit Notes in Non-Hospital Systems,” to support non-hospital systems across New York State in sharing open notes in compliance with recent federal rules and using open notes to more meaningfully engage patients. In 2023, NYHealth awarded The Door – A Center of Alternatives a grant to participate in this initiative.

The Door’s Adolescent Health Center is a federally qualified health center in New York City that provides comprehensive health care, health education, and wraparound youth development services to approximately 3,000 patients annually. Under this grant, The Door continued to implement and improve the use of shared notes within its system and participate in a technical assistance and peer-learning network. The Door enhanced the sharing and usability of notes through provider trainings on writing patient-friendly notes, adolescent confidentiality, and best practices in capturing coordinated care. It also conducted targeted patient education, outreach, and navigation in collaboration with its peer educators, as well as sought patient feedback on these engagement and provider training efforts to inform its approach.

See a full list of grantees participating in this initiative.

Shared visit notes, often referred to as open notes, are an important way to help consumers become active participants in their own care.

When patients have access to their own visit notes written by health care providers, they better remember and act on information discussed during visits, improve communication with their health care team, and better manage their health. The 21st Century Cures Act, a recent federal mandate, requires health care providers to make clinical notes available to patients electronically and at no charge. However, the level of compliance and, most importantly, the proactive use of open notes to improve care vary among health systems. In 2022, NYHealth issued a Request for Proposals (RFP), “From Good to Great: Improving Access to and Use of Patient Visit Notes in Non-Hospital Systems,” to support non-hospital systems across New York State in sharing open notes in compliance with recent federal rules and using open notes to more meaningfully engage patients. In 2023, NYHealth awarded Vocational Instruction Project (VIP) Community Services a grant to participate in this initiative.

VIP Community Services is a federally qualified health center and multi-service agency in the Bronx that provides primary care, mental health and addiction services, housing, and wraparound services to approximately 6,000 patients and clients annually. Under this grant, VIP Community Services continued to implement and improve the use of shared notes within its system and participated in a technical assistance and peer-learning network. It enhanced the sharing and usability of notes through provider training, notes audit, and the use of virtual scribes. VIP Community Services also conducted patient education and outreach and sought patient feedback.

See a full list of grantees participating in this initiative.

Shared visit notes, often referred to as open notes, are an important way to help consumers become active participants in their own care.

Established in 2010, OpenNotes is a national effort to give patients access to the visit notes written by their doctors, nurses, or other clinicians. Shared visit notes, often referred to as open notes, are an important way to help consumers become active participants in their own care. When patients have access to their own visit notes written by health care providers, they better remember and act on information discussed during visits, improve communication with their health care team, and better manage their health. The 21st Century Cures Act, a recent federal mandate, requires health care providers to make clinical notes available to patients electronically and at no charge. However, the level of compliance and, most importantly, the proactive use of open notes to improve care vary among health systems.

NYHealth has long supported the spread of open notes throughout New York State. In tandem, NYHealth has awarded grants to Beth Israel Deaconess Medical Center, where the national OpenNotes program office is based, in 2019, 2021, and 2022 to help cohorts of NYHealth grantees implement their open notes projects. In 2023, NYHealth awarded a grant to the Beth Israel Deaconess Medical Center to support 14 non-hospital systems as they undertake projects to share open notes in compliance with recent federal rules and use open notes to more meaningfully engage patients.

Under this grant, OpenNotes leadership at Beth Israel Deaconess Medical Center will provide technical assistance to help this cohort of grantees implement and expand open notes at their health systems. Specifically, OpenNotes staff will lead a 12-month technical assistance and learning network, which includes monthly group sessions and access to individual support from the OpenNotes team. Systems will learn from experts and each other, focusing on strategies to ensure that (1) providers are equipped with the tools to make note-sharing easy and useful; and (2) patients know how to access and use their visit notes productively. This technical assistance and learning network will cover a range of topics, including the new federal mandate; effective communication strategies to introduce open notes to both providers and patients; patient-friendly note-writing and note translation; and note-sharing for adolescent, pediatric, and behavioral health, among other areas.

See a full list of grantees participating in this initiative.

Shared visit notes, often referred to as open notes, are an important way to help consumers become active participants in their own care.

When patients have access to their own visit notes written by health care providers, they better remember and act on information discussed during visits, improve communication with their health care team, and better manage their health. The 21st Century Cures Act, a recent federal mandate, requires health care providers to make clinical notes available to patients electronically and at no charge. However, the level of compliance and, most importantly, the proactive use of open notes to improve care vary among health systems. In 2022, NYHealth issued a Request for Proposals (RFP), “From Good to Great: Improving Access to and Use of Patient Visit Notes in Non-Hospital Systems,” to support non-hospital systems across New York State in sharing open notes in compliance with recent federal rules and using open notes to more meaningfully engage patients. In 2023, NYHealth awarded Union Community Health Center (UCHC) a grant to participate in this initiative.

UCHC is a federally qualified health center in the Bronx providing primary and preventive health care—including medical, dental, behavioral health, and physical and occupational therapy services—to approximately 30,000 patients across 7 sites, including 2 mobile health units. Under this grant, UCHC continued to implement and improve the use of shared notes within its system and participated in a technical assistance and peer-learning network. It conducted patient education, outreach, and navigation. It also sought out patient feedback to understand barriers to notes access and opportunities to improve usability.

See a full list of grantees participating in this initiative.