DesRoches CM, Salmi L. Designing for techquity: Ensuring open notes serve all patients. JCO Clinical Cancer Informatics. 2025;(9). doi:10.1200/cci-25-00290
Cait DesRoches and Liz Salmi reflect on the evolution of open notes and issue a clear call to action for oncology. OpenNotes began as a multisite trial led by Tom Delbanco and Jan Walker and has become the “law of the land” in the United States. Drawing on over fifteen years of research, they underscore that while open notes consistently strengthen trust, understanding, and patient engagement, access is not equitable. They argue that transparency without equity is incomplete. The editorial challenges oncology leaders to move beyond compliance and intentionally design systems, workflows, and technologies (including patient-centered AI tools) that ensure all patients can benefit from reading their notes.
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