About The Study: The 21st Century Cures Act mandated that patients have immediate access to clinical notes and other health information (i.e., open notes). At a large, integrated health system, open notes engagement increased rapidly following implementation and plateaued at 55% within 2 months, with substantial sociodemographic disparities in engagement. These disparities may be attributed to the digital divide. Language may be another barrier, as notes are not routinely translated despite multilingual portal interfaces.
Corresponding Author: To contact the corresponding author, Ishani Ganguli, MD, MPH, email iganguli@bwh.harvard.edu .
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(doi:10.1001/jamahealthforum.2026.2097)
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