Susan Wolver, MD, Associate Professor Internal Medicine, Deborah Burgett, RN, MSHA, Director of Office of Clinical Transformation, Colin Banas, MD, MSHA, CMIO and Associate Professor Internal Medicine, and Rich Pollack, CPHIMS, CIO, VCU Health. Dr. Wolver and team discuss the VCU Health journey to improving patient engagement through the use of a patient portal and their recent implementation of OpenNotes within the portal. They walk through obtaining clinician buy-in and outlining the steps of the implementation process, as well as dicuss trends and future directions after one year of being live with this new level of patient transparency.