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Upstate awarded grant to improve access to patient visit notes

Upstate Medical University is one of 16 hospitals statewide to receive a grant from the New York State Health Foundation (NYSHealth) to enhance patient note-sharing.

Upstate will receive $50,000 through the program called “From Good to Great: Improving Access to and Use of Patient Visit Notes.”

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.

The 21st Century Cures Act, which went into effect last year, included a federal mandate that requires health care providers that maintain electronic medical records to make clinical notes available to patients electronically and at no charge.

These NYSHealth awards will provide hospitals with funding, technical assistance, and peer-learning opportunities to help them to comply with the new federal mandate but also to use open notes to spark a culture change and more meaningfully engage patients. NYSHealth is awarding nearly $800,000 towards this effort.

Cathy Narcavage-Bradley, DNP, RN, clinical outpatient health educator, said the project will focus both on patient and provider education. She said the patient education piece will focus on letting the community, especially marginalized populations, know that they have a right to these notes and how to access them.

She said that when Upstate applied for the grant, 47 percent of patients at Upstate had active MyChart accounts, but only 13 percent of patients have been viewing their notes. Prior to the change in the law, patients had to make a formal request for their medical records and sometimes were charged for them.

She said the marketing push will include things like brochures, posters, videos and TV ads.

“It’s really getting the word out that this is being provided by anyone, whether you are getting care at Upstate or elsewhere,” said Narcavage-Bradley. “It really is a movement.”

According to Opennotes.org, patients who read notes report that they have a better understanding of their health and medical conditions, they recall their care plan more accurately and are better prepared for their visits. Overall, they feel more in control of their care, take better care of themselves, and have stronger relationships and better conversations with their doctors.

“You go to your appointment, you’re talking to your provider and you’re nervous and they give you instructions and you leave there, and you forget,” she said. “Now you can go to the note and read it.”

Bradley said the benefits of note sharing are especially true for socio-economically disadvantaged, underserved populations such as those with lower income or education levels.

“There has been some research showing that for marginalized populations this can be beneficial as far as being able to improve their experience of care and improve trust in their care providers,” Bradley said.

Another component of the project will be to work with providers on how to simplify jargon and abbreviations in their notes to make them more understandable to their patients.

Narcavage-Bradley said the grant work will be piloted in Upstate’s Family Birth Center and in ambulatory settings and then pushed out campus-wide.

“I think it just is going to help improve this whole process and experience hopefully for the patients and the providers,” she said. “Improve care, education, as well as the patient experience.”