OpenNotes

academic healthcare-transparency initiative

OpenNotes

Industry Health

An academic initiative based at Beth Israel Deaconess Medical Center that studies and promotes patient access to clinical notes. OpenNotes scores well because it shifts information power toward patients and care partners, though it is an advocacy and research layer rather than a direct healthcare provider.

Why this matters: Clinical notes are an accountability surface: patients cannot meaningfully share power if records are hidden from them.

Letter grade A Good High confidence (AI) Rubric gcd-rubric-v1

Final Score 53* A - Good

* Tentative scaffolding score. Not human-checked or final.

Base Material49
Bonus+4
Cap66No structure cap
After Cap53
Penalties0
!Not Verified
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Evaluation Overview

A - Good

The score turns mainly on Extraction; no penalty currently dominates the evaluation.

Strengths

  • Extraction8/10
  • Ownership6/10
  • Governance6/10

Penalties

  • No penalties applied in this version.

Evidence state

  • ConfidenceHigh confidence (AI)
  • ThoroughnessDeveloped (AI)
  • Linked claims12
  • Direct axis claims12
  • Coverage12/12

Scoring Axes

Axis Score Why this score
Ownership
?
Control rights: shareholder-dominated at 0, worker cooperative control at 10.
6 / 10

OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Governance
?
Binding decision authority: centralized control at 0, democratic stakeholder control at 10.
6 / 10

OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Extraction
?
Surplus allocation, wage share, CEO pay ratio, margins, and structured extraction judgment.
8 / 10

OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Labor Sovereignty
?
Worker power: coercive conditions at 0, co-determination or ownership at 7. Employee dissatisfaction matters only when source-backed evidence shows concrete limits on worker agency, such as coercive scheduling, retaliation, wage theft, harassment, unsafe conditions, suppression of worker voice, or extreme turnover.
4 / 7

OpenNotes's linked public materials do not show ordinary workers holding full binding democratic control over the institution.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Solidarity with the Unemployed
?
Treatment of exits and nonworkers, including severance, redeployment, and non-competes.
6 / 7

OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Loss-Bearing Fidelity
?
Willingness to absorb costs to preserve values, workers, users, and public obligations.
5 / 7

OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Market Conduct
?
Pricing fairness, switching costs, lock-in, and rent extraction.
5 / 5

OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Product Integrity
?
Preservation of quality rather than degradation for monetization.
5 / 5

OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • context OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]
Scale Integrity
?
Whether growth improves or degrades fairness and accountability.
4 / 5

OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • context OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category. [1]
  • context OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers. [2]
  • context OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery. [3]
  • context OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution. [4]
  • context OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power. [5]
  • context OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise. [6]
  • context OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice. [7]
  • context OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability. [8]
  • OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities. [9]

Penalties

No penalties applied in this version.

Bonus Credits

Bonus Credit Why this credit
Openness to Dissent
?
Credit for tolerating internal, user, customer, worker, and public dissent without retaliation, capture, or viewpoint laundering.
2 / 3

OpenNotes's public record makes Openness to Dissent relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • OpenNotes's public record makes Openness to Dissent relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability. [10]
Constitutional Spirit
?
Credit for respecting constitutional rights and civil-liberties norms even where private law does not strictly require it.
1 / 3

OpenNotes's public record makes Constitutional Spirit relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • OpenNotes's public record makes Constitutional Spirit relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability. [11]
Cost Transparency
?
Credit for clear posted prices, all-in fees, unit costs, public rate cards, margin/cost visibility, or surplus-allocation transparency, especially in markets where opaque quotes, hidden fees, or individualized pricing are normal.
1 / 3

OpenNotes's public record makes Cost Transparency relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability.

Calibration notes

Comparative anchor: Coverage-gap batch calibrated across tax filing, utilities, housing, storage, healthcare systems, and childcare/youth institutions.

Linked evidence
  • OpenNotes's public record makes Cost Transparency relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability. [12]

Confidence Basis

Confidence Basis

Confidence is computed from the evidence trail and review state, not typed into the profile by hand.

High 80/100

12 verified linked claims 12 direct axis claims 0 disputed claims 12/12 components covered

This confidence label measures the source-backed evidence trail. AI-scaffolded scores remain tentative until human review.

Claim confidence 17/20

12 verified linked claims

Source quality 10/18

Best source per verified claim, weighted by institutional reliability

Direct axis-specific claims 14/18

12 direct claims across 12 active components

Dispute load 12/12

0 disputed claims on this entity

Recency 10/10

Newest accepted timestamp: May 13, 2026

Reviewer status 7/12

Human-reviewed components score higher than AI scaffolding

Component coverage 10/10

12/12 evidence-bearing components have direct support

Evidence State

Evidence State

Profile stateAI draft / human-pending
VerificationUnverified
ConfidenceHigh confidence (AI)
ThoroughnessDeveloped (AI)
Correction routeUse “Challenge this rating” for factual errors, missing counterevidence, source problems, or calculation mistakes.
Company responseCompany representatives can submit source-backed corrections; payment never changes scores or reviewer authority.

Claims and Sources

Claims are the evidence record. Each claim needs a source link, axis category, status, confidence level, and timestamp before it can support a score.

* Tentative scaffolding score. Not human-checked or final.
1OpenNotes's public record identifies its ownership form, institutional type, or public/private/nonprofit/cooperative structure in the health category.

Ownership Verified High confidence Human-reviewed

2OpenNotes's public record indicates whether binding control sits with shareholders, executives, members, public officials, nonprofit boards, residents, patients, or customers.

Governance Verified High confidence Human-reviewed

3OpenNotes's model determines whether money flows primarily to investors and owners or back toward users, members, public value, community services, affordability, or mission delivery.

Extraction Verified High confidence Human-reviewed

4OpenNotes's public materials do not show ordinary workers holding full binding democratic control over the institution.

Labor Sovereignty Verified Medium confidence Human-reviewed

5OpenNotes operates in an everyday-need category where job loss, illness, rent pressure, family-care obligations, tax compliance, utility dependence, or household instability affects bargaining power.

Solidarity Unemployed Verified Medium confidence Human-reviewed

6OpenNotes's product or service can absorb real household, civic, care, housing, energy, or tax-compliance risk, but the record also shows who bears costs when the institution fails or prices rise.

Loss Bearing Fidelity Verified High confidence Human-reviewed

7OpenNotes operates in a market where customers, tenants, patients, taxpayers, utility users, parents, or community members often face switching costs, asymmetric information, or limited choice.

Market Conduct Verified High confidence Human-reviewed

8OpenNotes's core service has practical everyday utility, but its integrity depends on pricing, safety, transparency, access, quality, data handling, and accountability.

Product Integrity Verified High confidence Human-reviewed

9OpenNotes's scale or category makes its decisions consequential for ordinary U.S. households, patients, tenants, parents, taxpayers, utility customers, or communities.

Scale Integrity Verified High confidence Human-reviewed

10OpenNotes's public record makes Openness to Dissent relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability.

Openness To Dissent Verified Medium confidence Human-reviewed

11OpenNotes's public record makes Constitutional Spirit relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability.

Constitutional Spirit Verified Medium confidence Human-reviewed

12OpenNotes's public record makes Cost Transparency relevant through its ownership, pricing, safety, lobbying, environmental burden, youth exposure, data practices, lock-in, public mission, or community accountability.

Cost Transparency Verified Medium confidence Human-reviewed

Alternatives

Competitors

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How This Page Is Maintained

Evidence comes in through contributors, is checked by verifiers, and is synthesized by reviewers. Founder authority remains narrow and visible; scores recalculate when verified claims or the rubric change.

Civic Note

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Audit Log

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