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Open Notes for Patients

doctor writing on a medical chart

I discuss personal health records with my graduate students in health informatics every year. It always reminds me of the Open Notes Initiative which you can learn more about here.

Sharing notes can improve communication among patients, families, and clinicians, build stronger, more trusting relationships, enhance patient safety, and strengthen adherence to medications.

I first learned about this call to action for greater transparency nearly a decade ago. In fact, I moderated a #HealthXPH tweet chat in 2014, entitled Will doctors let patients read what they write? How much progress have we had since then in espousing patient-centered care? Even back then, I learned from patient advocates on Twitter who declared, Nothing about me, without me.

Let’s revisit this topic tonight at the #HealthXPH tweet chat, 25 Nov 2023 9 pm Manila time.

T1. As a physician, will you let patients read your notes in their medical records? As a patient, do you want “open notes”?

I’m still doing teleconsultations. I started doing teleconsultations during the pandemic. As part of my workflow, I email my patients a summary of the televisit. Just last week, my summary said that I will write a referral letter to the obstetrician for my pregnant patient with gestational diabetes. I forgot to attach the letter to the email! My patient promptly replied to clarify since I had told her during the teleconsultation that I would write the letter. Good save!

T2. If patients can read your notes in their medical charts, will that change the way you write notes as their physician?

At my clinic, it is possible for the patients to view the monitor as I type. But I find that sending the teleconsultation summary allows me to write remarks.

HbA1c 8.5% above target of less than 7%. [You promised you will make wiser food choices!]

Sentence enclosed in brackets is my note to the patient.

I’ve also had to think about my email sign-off now that I’m emailing patients. For me it’s –


Dok Iris

T3. What are your thoughts on patients sharing their medical records on social media?

I have not had any patient sharing their medical records on social media. Lab results yes, or narrating the course of their disease. Sometimes I see other patients (not mine) sharing the prescriptions of their doctors. Sometimes, it’s to ask others if they can make sense of the doctor’s handwriting, yikes!

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