Shared Notes and Shared Decisions with Patients
Empowering Health Care Consumers
April 4, 2022
Clinical visit notes are an important resource for helping patients and families remember and act on information discussed during a visit, including treatment plans, medication, and care coordination.
Shared visit notes, often referred to as open notes, are an important way to help consumers become active participants in their own care. The 21st Century Cures Act, which went into effect last year, includes a federal mandate that requires all health care providers that maintain electronic medical records 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 varies. For some hospitals, note-sharing is embedded into their practice, and they are ready to expand the types of notes and information they share and to test out innovative ways to meaningfully engage patients. For others, note-sharing is new territory, and they can benefit from adapting proven tools to their own settings and learning best practices from more experienced hospitals. In 2021, NYHealth issued a Request for Proposals (RFP), “From Good to Great: Improving Access to and Use of Patient Visit Notes,” to support hospital facilities in New York State in sharing open notes in compliance with new federal rules and in going beyond compliance to use open notes to more meaningfully engage patients. In 2022, NYHealth awarded State University of New York Health Science Center at Syracuse (SUNY Upstate) a grant to participate in this initiative.
Under this grant, SUNY Upstate implemented and improved the use of shared notes at its hospital site, promoting greater information transparency and engaging patients in their care. SUNY Upstate undertook an open notes expansion at Upstate University Hospital. Located in Syracuse, Upstate University Hospital is the only academic medical center and tertiary care provider in the Central New York region, providing a range of specialty and subspecialty care to a service area of 1.7 million residents. With this grant, Upstate University Hospital launched marketing and patient education campaigns on shared notes; gathered feedback from patients and providers to support patient portal improvements; and trained providers in shared decision-making practices. As part of this project, its Family Birth Center also focused on data-sharing and shared decision-making in maternity care. SUNY Upstate also participated in a 12-month learning collaborative led by OpenNotes staff to explore strategies and tools for note-sharing, including understanding the new federal mandate; sustaining clinician engagement; adopting effective communication strategies to introduce open notes to both providers and patients; and sharing notes in the context of adolescent, pediatric, inpatient, and behavioral health settings, among other areas.