OpenNotes, the initiative that launched in 2010 to encourage doctors to open up their clinical notes to their patients, has received $10 million in new funding to expand its movement to 50 million patients over the next three years. The funding comes from the Cambia Health Foundation, the Gordon and Bettye Moore Foundation, the Peterson Center on Healthcare, and the Robert Wood Johnson Foundation, which originally funded the initiative five years ago.

“Our research shows increasingly that patients can benefit greatly from reading the notes taken during a medical visit. They tell us they feel more in control of their care and are more likely to follow up on recommendations,” Jan Walker, RN, the co-founder of OpenNotes said in a statement. “This has enormous implications for improving the quality and costs of care. Moreover, we’re learning that having a second set of eyes on the record may be an important way to improve patient safety.”

Beth Israel Deaconess Medical Center and Harvard Medical School, where Walker is an assistant professor of medicine, completed a five-year retrospective study of the data in August and found that often OpenNotes patients helped doctors catch medication errors and remember next steps. Having access to notes improved patients' adherence to treatment plans, improved care coordination, and helped some patients to get diagnosed more quickly.

The new funding will go to assisting new providers in adopting OpenNotes and continuing to fund efficacy research on outcomes and costs. An advisory board will select which organizations, clinicians, and consumers to reach out to. A special focus is going to go into reaching out to consumer and patient advocates as well as clinical organizations.

"We already do a lot of support to help institutions who are considering OpenNotes and those efforts will ramp up considerably," a BIDMC spokesperson told MobiHealthNews in an email. "We'll be developing a more robust website with downloadable educational materials, videos, tool kits -- and there will be more staff who can work directly with institutions to help with implementation. We'll continue to work with institutions that are already using OpenNotes, but the goal really is to get more institutions participating so that OpenNotes becomes the standard of care."

Originally funded by a Robert Wood Johnson Foundation grant, the OpenNotes initiative began five years ago. The movement to make clinicians’ notes available to patients began to generate headlines in 2012 when researchers at Beth Israel found that patients with access to clinician notes were more engaged and saw better outcomes. The results from the year-long study of more than 13,500 primary care patients and 100 physicians were published in the Annals of Internal Medicine.

The OpenNotes movement has spread to the Cleveland Clinic, the Mayo Clinic, Geisinger Health System, and nine hospitals in the northwest that adopted it en masse in April 2014, to name just a few. More than 5 million patients nationwide now have access to their notes. Meanwhile Beth Israel has continued to push the limits of note-sharing: last July the hospital made the controversial move of expanding the practice to mental health specialists, and in January they launched a new pilot that would allow patients to not only read but contribute to their notes.

“OpenNotes will make clinicians’ thinking far more transparent, and that holds both complex and exciting implications for patients, for their family members, and for the host of health providers who care for them. This is particularly true for vulnerable populations, and patients with a large burden of chronic illness, including mental illness,” Dr. Tom Delbanco, another co-founder of OpenNotes and primary care doctor at BIDMC, said in a statement. “Opening the doctor’s black box breaks down traditional barriers and provides a foundation for all kinds of exciting innovations in health care, changes that in my view will benefit the vast majority of patients and their clinicians."