Disparities in accessing open notes at a comprehensive cancer center.

Abstract

e18507 Background: Patient use of open access medical notes can promote understanding of and engagement in disease management, in turn improving patient satisfaction, trust, medication adherence and clinical outcomes. Previous studies have shown that racial minorities were less likely to utilize personal health records online, as were patients with lower incomes compared to those with higher incomes. The CURES Act, enacted as of April 5 2021, is a national policy that requires healthcare providers to give patients access to the information and notes available on their own electronic medical registry. Given the recency of this legislation, little is known about who is accessing this information or how we can help it to be more widely accessible. Methods: We extracted demographic data available for all patients with an outpatient oncology encounter at UCSD between 1/1/21-12/31/21. Data available included age, gender, ethnicity, preferred language, and type of insurance. Mann-Whitney U test and Fisher’s exact test were used to compare continuous and categorical variables between the two groups, respectively. This analysis was approved by the UCSD ACQUIRE committee and met criteria for IRB excusal. Results: There were 22,419 patients who met inclusion criteria, 21,892 (97.3%) of whom were registered on MyChart and 4,114 (18.4%) of whom had accessed an oncology note. There was no significant difference in age or gender between those who did or did not access notes. Patient race, ethnicity, preferred language, and insurance type were all significantly different between groups (p<0.001), with those who were non-White, Hispanic, Spanish speaking, or on Medicaid less likely to access their notes through OpenNotes. Conclusions: There are significant differences in the demographics of patients who do and do not access notes. Targeted outreach efforts (e.g., translation efforts) may help in making access to open notes more equitable. [Table: see text]