The 21st Century Cures Act: More Harm Than Good for Survivors of Intimate Partner Violence?

The 21st Century Cures Act requires that health organizations make all medical records rapidly available to patients through secure online portals. Referred to as "open notes," this approach is intended to improve health outcomes by facilitating easier and more transparent communication between patients and providers. For patients experiencing intimate partner violence (IPV), however, open notes can create serious safety risks to their physical and mental health when not handled carefully. This clinical note aims to raise awareness of how open notes can be harmful in IPV situations, provide a set of evidence-informed recommendations on how healthcare providers and institutions can help to mitigate this harm, and outline areas for future research.