Use and Usefulness of After-Visit Summaries by Language and Health Literacy among Latinx and Chinese Primary Care Patients

Abstract

The after-visit summary (AVS), a document generated from the electronic health record that summarizes patients’ encounters with the healthcare system, is a widely used communication tool. Its use by and usefulness for populations with limited English proficiency (LEP) and limited health literacy (LHL) is poorly understood. In this cross-sectional study, we assessed use and usefulness of the AVS among English-, Spanish-, Cantonese-, or Mandarin-speaking Latinx and Chinese primary-care patients. Outcome measures were self-reported AVS use (did not use/looked-at only/shared only/looked-at and shared) and usefulness (useful/not useful). Among 993 participants, 57% were ≥65 years old, 61% had LEP, 21% had LHL, 30.2% were Latinx, 69.8% were Chinese. The majority used the AVS (86%) and found it useful (65%). In adjusted models, participants with LEP were more likely to “look at” (OR 1.68, 95% CI 1.07–2.62) and “look at and share” (OR 1.65, 1.02–2.66) the AVS, but less likely to find it useful (OR 0.68, 0.47–0.98) compared to English speakers. Those with LHL were less likely to “look at” (OR 0.60, 0.39–0.93) and less likely to find the AVS useful (OR 0.67, 0.46–0.99) compared to those with adequate health literacy. Our results emphasize the need for easy-to-understand and fully language-concordant AVS.