Article Title

OpenNotes® –– Building Relationships With Patients for Better Health and Health Care

Publication Date



progress notes, after visit summary


Background/Aims: OpenNotes® is a nationwide initiative supported by Robert Wood Johnson Foundation that offers patients ready access to progress notes of doctors and other clinicians after an office visit. In the original OpenNotes demonstration and evaluation project, patients were invited over email to read a note once it was signed by a primary care physician. The majority of patients in the study viewed notes and reported clinically relevant benefits. We know little about how many patients will view notes in the absence of a notification from a provider once the note is signed. The objective of this poster is to perform descriptive study on Epic/Clarity page views data and provide insights on how many notes are hidden and viewed using desktop/mobile devices.

Methods: We tracked all the face-to-face visits to the providers and associated notes data in the electronic health record (EHR) from April 10, 2015, to Sept. 10, 2015. We then linked EHR data to web server activity log based on medical record number and date to quantify notes accessed via desktop/mobile devices and mobile applications. We used Venn diagrams and Microsoft Excel graphs for visualization of results.

Results: Of the 679,111 outpatient visits during the period, 90% (610,625) had any associated note, 10% (68,486) did not, 96% (608,249) were accessible and 4% (2,376) were hidden from patient. Only 5.7% (34,780) of notes were viewed at least once during study period. Overall, there were 104,071 note views, i.e. 54,755 notes viewed at least once during the 5 months regardless of visit date, of which 19,975 notes were related to visits prior to April 10, 2015. We were able to match 104,019 (99.95%) EHR data to web activity log data. There were 52 (0.05%) unmatched records specific to Epic/Clarity alone. Web browsers accounted for 91.7% (95,473) of views [80.4% (83,662) desktop, 11.35% (11,811) mobile], 4.7% (1,470) were AVS views on Group Health mobile application and 6.8% (7,076) were viewed on unknown device.

Conclusion: Desktop and mobile browsers continue to be popular platforms for viewing clinicians’ notes. One of the reasons for low progress notes views is attributed to lack of active promotion on availability of EHR notes by Group Health Cooperation at that time. Group Health clinicians will continue to inform their patients that they can review the after-visit notes online.




June 30th, 2016


August 12th, 2016