- Following in the footsteps of the OpenNotes project, Beth Israel Deaconess is allowing 700 mental health patients access to their physicians' notes. Patients can read their therapy session notes on mobile or desktop within days of their appointment.
- The project is controversial. Proponents advocate for equality between mental health and medical patients while others are concerned that there may be a negative impact on privacy, confidentiality and outcomes.
- Last year, the Department of Veteran Affairs opened both medical and mental health records to patients, but the agency has not begun to analyze the results yet.
Patients have the right to their health records; however, if a doctor thinks reading notes would be harmful to the patient or others, he or she can withhold them. One risk that psychiatrists have raised is the density of clinical language: "Diagnostic language is used among doctors to describe features of a mental illness," said Dr. Brian Clinton, Columbia University Medical Center. "I would be willing to discuss with a patient what I think. It’s a better way to communicate than a note I wrote for other doctors."
Nina Douglass, a clinical social worker, expressed concern that patients with abusive partners might be at risk if the abuser forced access to the notes. While Douglass can see clinical benefits to opening notes, "One size doesn't fit all."
Still other clinicians expressed concerns that for smaller practices, the administrative and financial hurdles to implement similar programs might be insurmountable.
The original OpenNotes project was launched in 2011 and provided 22,000 patients access to their physicians' notes.