How to get the most out of your children’s notes

Open notes help kids engage with their health, and they make it easier for you and your family to manage care across health systems.

After a visit or any discussion with you and your child, your doctor writes a note summarizing your visit. The note can include symptoms, a description of the exam, or an overview of test results. It may also contain details about the treatment plan and next steps. All of this becomes part of your child’s medical record.

Parents can access their child’s medical records using their health care system’s online patient portal. Using the patient portal, you can request appointments, message your child’s health care team, and view your child’s health record. If your child’s doctor or nurse does not use a patient portal, you can request a digital or paper copy of their records.

Manage your child’s health care. You can see your child’s open notes wherever and whenever you want. Notes can remind you and your child what was discussed during an office visit. Reviewing the record and notes can help make sure that your child, you, and the care team are on the same page.

Communicate concerns. Reviewing notes is important for many reasons. You might identify mistakes in the note and then share concerns with your child’s health care team. You can also let the care team know if you or your child don’t understand the care plan or are unable to follow recommended next steps.

Share notes with others involved in care. Schools often ask parents to fill out a health form at the beginning of each year. It can include a vaccination record or a description of how a child’s health conditions are managed. Your child’s open notes can help you recall important details. You can share portions of the notes with the school nurse or anyone you think needs more details about your child’s treatment plan.

Help children learn to navigate the health care system. Reading notes with your children can help them feel more empowered and in control of their health. It can also help you and your family become more informed and engaged with the health care system.

All clinicians involved in your child’s care have access to the information contained in the medical record, including the notes. But doctors, nurses and all health care professionals operate under strict rules guarding your family’s confidentiality. Open notes do not change those rules.

As a parent or legal guardian, you can choose to share medical information with others involved in your child’s care. This collaborative approach ensures that patients and specialists are well-informed on treatments and progress.

To help ensure your privacy, keep your patient portal login name and password private.  Always remember to sign out whenever you look at your child’s health record.

Laws dictating when adolescents are old enough to seek “confidential” health care services differ from state to state. Clinicians may have private conversations with an adolescent about sensitive or confidential topics and may choose to not share that information through the portal. It’s important to discuss access to health information with your adolescent and their care team.

For example, At Boston Children’s Hospital, adolescents can create their own accounts to access their health information without parental consent. However, they cannot view secure messages sent directly between the parent/guardian and the health care team. Parents/guardians, on the other hand, cannot view:

  • Secure messages between the adolescent and the health care team.
  • Confidential appointments or confidential health information.

Parents/guardians will still be able to access all of their child’s non-confidential information. Confidential information may include: test results, reports, medications, and visit notes that include sensitive information.

“We believe it’s important to allow parents access to their adolescent child’s non-confidential medical information, as many parents continue to play an important role in helping adolescents assume responsibility for their medical care and guiding them through healthcare decisions.”
—Fabienne Bourgeois, MD, MPH, pediatric hospitalist and Medical Director of Patient-Facing Applications, Boston Children’s Hospital

  • The note may not be ready. After the clinician writes and approves the note, it will become available.
  • The clinician may have chosen to not share the note through the portal because it contains sensitive information. In this case, you will not be able to gain access to that note.
  • You may need to request access. Your health system should have a request process in place, and you should get access to the notes within three days of making the request.
  • If you have requested access to the notes, and you still cannot find them, you may need help navigating the portal. Try contacting your patient portal’s support team, so they can help you find the notes.
  • If there is no request process or your request is denied or delayed, you may be experiencing information blocking. You can report information blocking here.

Keep in mind that the note is part of your child’s medical record. Doctors use the note to manage your child’s care and to communicate with others involved in their care. You may find the note difficult to read because it includes medical jargon. It’s okay to use trusted online resources to look up information. You can contact your health care team if there’s something you don’t understand. You should also contact them if you are unable to follow the care plan or if you have concerns about aspects of your child’s care.

If you see an error or inaccuracy that could affect your child’s care, your care team will want to know. Never hesitate to call or send a secure message.

View additional FAQs about how to get the most out of notes here.