The difference between open notes and the Cures Act Final Rule

The 21st Century Cures Act was signed into law by President Obama in 2016 with overwhelmingly bipartisan support. Information sharing is central to the Cures Act Final Rule released by the Office of the National Coordinator for Health Information Technology (ONC) in 2022. Some refer to this as the “information sharing rule.” It mandates that patients have rapid, free and full access upon request to test results, medication lists, referral information, and clinical notes, all in electronic formats.¹

Some also refer to the Cures Act Final Rule as the “Open Notes Rule.” This is inaccurate. Although ONC strongly supports the concept of ‘open notes’ and work by the OpenNotes movement headquartered at Beth Israel Deaconess Medical Center, the Cures Act Final Rule and ‘open notes’ are not synonymous. The Rule extends well beyond clinical notes.

See the ONC’s relevant FAQ about clinical notes.

Learn more about the Cures Act Final Rule and what it means for patients and clinicians.

What is an open note?

After office or tele-visits, doctors, nurses and other health care providers write notes that summarize important information about their patients. Notes become a part of a person’s medical record, and when notes are shared with patients they become an ‘open note.’ Learn more about open notes for patients.

Who is OpenNotes?

OpenNotes is an international movement spreading, studying, and teaching about transparent communication among patients, families, and clinicians. When clinical notes are shared with patients, we call these ‘open notes.’ Based at Beth Israel Deaconess Medical Center, a major Harvard Medical School teaching hospital, OpenNotes is not-for-profit and is funded entirely by federal and philanthropic grants and gifts. It does not develop software and is not a technology company.