Transparent communication between doctors and patients

The right of patients to have access to their own health information has been enshrined in Germany's Basic Law since February 2013. In theory, this provides a good basis for following the so-called OpenNotes movement from the USA, which aims to create absolute transparency in the exchange between doctors and patients. While the "open record" has now been mandatory in the USA since April 2021, the Witten Primary Care Clinic for Integrative Health Care and Naturopathy is doing pioneering work in Germany.

Open notes: patients have access to their records

"Open Notes" means something like "open grades". This refers to medical notes and records that should be "open" to patients, i.e. accessible at all times. The concept originated in the USA, where it was developed at Harvard Medical School in Boston and initially introduced in practice in a large study in 2010. The aim is to improve the relationship of trust between patients and doctors and to make communication more transparent. Last year, more than 50 million Americans already had digital access to their records.

Since 1 April 2021, the provision of Open Notes has been mandatory for almost all medical fields in the USA. "This is a real milestone, a very positive development," says a delighted Prof Dr Tobias Esch, Head of the Institute for Integrative Health Care and Health Promotion at Witten/Herdecke University. Until 2015, the doctor, neuroscientist and health researcher himself worked in the OpenNotes team in Boston and brought the topic from there to Witten. "In Germany, we are still a long way from such a standard. However, there is an increasing awareness of the relevance of good and transparent communication in medicine here too."

Witten University Outpatient Clinic is a pioneer in Germany

The Primary Care Clinic for Integrative Health Care and Naturopathy founded by Esch is the first and so far only institution in Germany to follow the OpenNotes movement. Via an online health portal, which is accessible via the outpatient clinic's website, patients can access their personal file with all documents at any time and from anywhere where they have internet access: Laboratory values, medication plans, ultrasound, X-ray or MRI images including comments and findings, audio or video recordings are stored here. In addition, all entries and notes made by the treatment team at the university outpatient clinic in the course of medical care are made available - one hundred per cent transparency is the aim and the goal.

"We firmly believe that OpenNotes and integrative healthcare that focusses on patients is the future of primary care in Germany," says Tobias Esch about the concept of the university outpatient clinic. "We still have a long way to go - but the Witten model is attracting a lot of attention, both in the professional world and in politics and the population, regionally, nationally and even internationally." The British Medical Journal, the world's leading specialist journal in general practice, is currently reporting on the "Witten Model".