OpenNotes enables patients and their designated caregivers to access medical records and provider documentation. Research has shown that this access may have the potential to improve medication adherence and patient engagement, and that patients may be able to identify errors in documentation. In this study performed at three distinct medical centers, researchers evaluated the effects of implementing a system for patients and families to report mistakes they saw in outpatient documentation. Of the 1440 reports obtained, 27% suggested possible inaccuracies and frequently prompted a change in the medical record. Symptom descriptions, past medical history, and medications were most commonly identified as areas of potential discrepancy by patients and families. An Annual Perspective discussed mechanisms for engaging patients as partners in safety.