Recently I sat patiently in an examination room while my physician typed notes into a computer terminal. After a few moments, he paused and asked, “You know what electronic medical records are good at?” I smiled politely. “Federal compliance and billing,” he said. I didn’t have to wait long for the follow-up I knew was coming. “You know what they’re bad at? Caring for patients.”

Earlier this year, the National Patient Safety Foundation’s Lucian Leape Institute released a report calling for greater transparency in healthcare as a means of improving patient safety. Defining transparency as “the free, uninhibited flow of information available to the scrutiny of others,” the report argues for transparency across all areas of healthcare: between clinicians and patients; among clinicians; between organizations; and with the public (NPSF Lucian Leape Institute, 2015).

In our cover feature, Deborah Wachenheim tells the story of a grassroots effort in Massachusetts that resulted in a mandate for every hospital in the state to have a patient and family advisory council (PFAC). Now, five years after the mandate went into effect, PFACs are in use in many hospitals across the country. Deborah, who was involved in the Massachusetts movement, also describes experiences and lessons learned in two hospitals—an academic medical center and a community hospital.