Is The Future Of Medical Notes One Of Co-Creation?

The digitization of medical records is something I’ve touched upon many times over the past 18 months, and a recent post explored some of the factors that have held this back, from time concerns from doctors to privacy concerns from patients.

Research led by Harvard Medical School examined this concept further via the notion of co-created medical notes.  In a recently published paper, the researchers document their development of a system known as OurNotes.  They report that encouraging patients to have more input into their personal medical records can help to improve their care and even their relationships with their doctor.


“If executed thoughtfully, OurNotes has the potential to reduce documentation demands on clinicians, while having both the patient and clinician focusing on what’s most important to the patient,” the authors say. “Piloting OurNotes will start at four centers in 2018.”

The researchers prepared for the pilot by conducting a number of detailed interviews with 29 health experts, ranging from primary care physicians to nurse practitioners.  All had used OpenNotes systems in the past, either as clinician or patient.

All were positive about the impact that OurNotes could have in boosting patient engagement and improving both the care provided to the patient and the collaboration levels between provider and patient.  It might even reduce some of the administrative burden on busy providers.

The interviews suggested that the best approach to securing that engagement was to contact the patient prior to a visit and ask them to review their previous notes.  Via this process, they can provide an internal history and list what they want to address at the upcoming visit.

“One can argue that reading a note is far less active than actually participating in producing a note. Transforming practice with OurNotes holds great promise for more active patient involvement,” the team say. “We’ve had a warm reception from clinicians who want to give OurNotes a try. They are intrigued by the notion that an interval history and agenda provided by a patient is a way to streamline the visit and address the patient’s priorities more effectively.”

Suffice to say, the concept of co-authored medical notes is still a rare one, but it’s a fascinating idea that I hope will spread further afield, especially as people take a greater interest in their own health and wellbeing.