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Case study 03 · Patient access & transparency

OpenNotes

Moving the conversation about clinical notes beyond portal access toward dignity, understanding and shared power.

Emily Foucault filming an OpenNotes testimonial video at CAMH
Emily Foucault filming a testimonial video at CAMH’s campus at 1051 Queen Street West in Toronto, 2025. Photo courtesy of CAMH.
01

Context

What shaped the work

Patients often have limited or inconsistent access to the clinical notes written about them. Even when notes are available, they may be incomplete, difficult to understand or written in stigmatizing language.

In mental health care, where notes can contain especially sensitive information, experiences of stigma, dismissal or trauma can make transparency central to trust.

02

Emily's role

Where Emily contributed

Emily contributed as a CAMH patient advisor, lived-experience collaborator, co-author and speaker. She brought the perspective of someone navigating complex care and helped turn broad questions about transparency into practical, real-world concerns.

03

Collaborative process

How the work happened

Emily worked as a thought partner with CAMH's Digital Mental Health Lab, researchers, clinicians and other patient advisors. Lived experience was used to ask different questions, identify risks and inform testimonial and knowledge-mobilization materials—not simply to endorse decisions already made.

04

Contribution

From insight to action.

  • Raised questions about trust, power, accuracy and restricted access.
  • Distinguished access to information from meaningful, understandable transparency.
  • Advocated for person-centred and trauma-informed clinical documentation.
  • Contributed to patient testimony and knowledge-mobilization work.
  • Presented at UHN's PiPER Research Day.
  • Wrote publicly about OpenNotes and clinical transparency.
06

Impact

What changed

  • Made the patient case for access to notes more visible to clinicians and organizations.
  • Framed OpenNotes as a trust and equity issue, not only a technology feature.
  • Highlighted the need for understandable and respectful documentation alongside access.
  • Supported practical implementation conversations in Canadian mental health care.