Even when health care systems offer open notes, doctors don't always explain to their patients how they work or their benefits, says John Santa, MD, director of dissemination at OpenNotes, These steps can help you obtain your full records.

Check availability. Ask your doctor if your health care system offers open notes. If your doctor isn't sure, go to OpenNotes.org for a complete, nationwide list of providers who use open notes.

Ask for access. Even in systems where notes are available, individual doctors often can choose whether or not to show notes to patients. Ask about it when choosing a new doctor—and consider switching physicians if your current one prefers not to share.

Sign up. Access isn't automatic, even if it's available. You need to go on to your health care system's online patient portal and register. Call your doctor's office for help if you find the process difficult or confusing, or if you have trouble finding where notes exist on the site.

Push for access. If your provider has a patient portal but doesn't provide open notes, let clinicians and administrators know you want to see your full records available through the system.

Ask your doctor for workarounds. Maybe the system won't provide open notes but your doctor will. Some physicians are amenable to printing out or copying their notes and giving them to patients or caregivers.

Request reminders. Actually reading your doctor's notes is up to you—and many patients don't, even when they can. Physician prompts can help. When doctors send encouraging reminders to look at notes, 50 to 60 percent of patients do so, according to Dr. Santa. When doctors send no encouragement, only 5 to 10 percent of patients look at notes.