Even routine abbreviations and jargon like “S.O.B.” (shortness of breath) and “anorexic” (a general lack of appetite, not the disease anorexia nervosa) could be confusing at best and inadvertently demeaning at worst. Doctors, already pressed for time, shuddered at the idea of suddenly being responsible for the worries of a reading public.

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In 1996, despite these concerns, the Health Insurance Portability and Accountability Act, or HIPAA, gave all patients the legal right to read and even amend their own medical records. At the time, a group of national health care experts hailed this new transparency as a necessary component of better and safer care.

But today, few patients have ever laid eyes on their own records. And those who try often come back from their missions with tales of bureaucratic obstacles, ranging from exorbitant copying costs to diffident administrators. The same concerns from 40 years ago come up again and again, with little evidence to support or refute the claims of either side. Should medical records be shared as interactive documents between patients and physicians? Can transparency work, or will it end up worrying patients, muddling the patient-doctor relationship and adding more work to an already overburdened primary care work force?

Now, according to the latest issue of the Annals of Internal Medicine, the answers to these questions may finally be answered in a year’s time.

This summer, researchers have begun the largest study to date of open access, aptly named Open Notes, involving over 100 primary care physicians and approximately 25,000 patients from three health care centers  the Beth Israel Deaconess Medical Center in Boston, the Geisinger Health System in Danville, Pa., and the Harborview Medical Center in Seattle. In the study, patients who have just seen their doctors will receive an e-mail message directing them to a secure Web site where they can view the signed physician notes. Patients will receive a second e-mail message two weeks prior to any return visit, reminding them that the notes from their previous visit are available for review.

Over the course of the yearlong study, funded by the Robert Wood Johnson Foundation, the Open Notes investigators hope to analyze the expectations and experiences of patients and physicians, as well as examine the number of additional phone calls, e-mail messages and visits that may arise as a result of more patients viewing their doctors’ notes. In addition, a public survey on the journal’s Web site will assess the opinions of any patient or doctor not enrolled in the study.

“We have one simple research question,” said Dr. Tom Delbanco, a lead investigator who is a primary care physician at the Beth Israel Deaconess Medical Center. “After a year, will the patients and doctors still want to continue sharing notes?”