Sharing Notes With Adolescents and Young Adults Admitted to an Inpatient Psychiatry Unit

Since its inception in 2012, the OpenNotes initiative has been broadly adopted by medical institutions across the nation, giving more than 40 million patients access to their medical documentation. The response to this access has been overwhelmingly positive, as providers and adult patients report increased trust, transparency, and collaboration. In contrast, the benefits of OpenNotes have yet to be realized among pediatric and adolescent patients. Since February 2018, our pediatric institution has default released medical notes to patients aged 12 years and older. Currently, 90% of medical notes are shared with adolescent and young adult (AYA) patients; however, medical documentation is withheld from those in care settings regarded as vulnerable (ie, psychiatry, child abuse) or if the provider deems the content sensitive. We previously demonstrated adequate comprehension and satisfaction with medical documentation among AYA patients seen at a pediatric gastroenterology clinic. However, confidentiality concerns persist among providers, especially those working within mental health settings..