Background The Cures Act mandated immediately released health information. In this study, we investigated patient comprehension of mammography reports and the utility of online resources to aid report interpretation. Methods Patients who received a normal mammogram from February to April 2022 were invited to complete semi-structured interviews paired with health literacy questionnaires to assess patient’s report comprehension before and after internet search. Results Thirteen selected patients via purposeful sampling completed interviews. Most patients described their initial understanding of the mammography report as “good” and improved to between “good” and “very good” after an internet search. Patients suggested "a little column on the side" for medical terminology, “an extra prompt" for making an appointment, or a recommendation for "good sites” to improve mammography reports. Conclusion Patients varied in their ability to independently interpret medical reports and seek additional resources. While online resources marginally improved patient understanding, actionable and clear resources are needed.

Background Through online health portals, patients receive complex medical reports without interpretation from their healthcare provider. This study evaluated the usability of MedEd, a patient engagement tool providing definitions of medical terminology in breast pathology and radiology reports. Methods Individuals who underwent a normal screening mammogram were invited to complete semi-structured interviews where they downloaded MedEd and discussed their download experience. Acceptability, appropriateness, and feasibility of MedEd were evaluated. Results 143 individuals were invited to participate, and 14 semi-structured interviews were completed. Participants reported ease of downloading and navigating MedEd with concerns about privacy and others’ abilities to download. Participants demonstrated high acceptability (mean 4.48/5, SD 0.95), appropriateness (mean 4.66/5, SD 0.83), and feasibility (mean 4.48/5, SD 1.04) scores. Conclusion Participants expressed excitement for future use of MedEd and provided suggestions for improvements. Next steps include evaluating comprehension of real breast reports while using MedEd and expanding patient access.

INTRODUCTION:As part of the 21st Century Cures Act (April 2021), electronic health information (EHI) must be immediately released to patients. In this study, we sought to evaluate clinician and patient perceptions regarding this immediate release. METHODS:After surveying 33 clinicians and 30 patients, semi-structured interviews were conducted with a subset of the initial sample, comprising 8 clinicians and 12 patients. Open-ended questions explored clinicians' and patients' perceptions of immediate release of EHI and how they adjusted to this change. RESULTS:Ten themes were identified: Interpreting Results, Strategies for Patient Interaction, Patient Experiences, Communication Strategies, Provider Limitations, Provider Experiences, Health Information Interfaces, Barriers to Patient Understanding, Types of Results, and Changes due to Immediate Release. Interviews demonstrated differences in perceived patient distress and comprehension, emphasizing the impersonal nature of electronic release and necessity for therapeutic clinician-patient communication. CONCLUSIONS:Clinicians and patients have unique insights on the role of immediate release. Understanding these perspectives will help improve communication and develop patient-centered tools (glossaries, summary pages, additional resources) to aid patient understanding of complex medical information.

AbstractBackgroundSociodemographic factors, including language, education, race, and insurance status, significantly influence patient outcomes following breast surgery, especially in safety-net hospitals (SNHs) that serve vulnerable populations.ObjectiveTo assess the sociodemographic composition of a breast surgical oncology clinic at an urban SNH and evaluate how these factors impact digital literacy, health literacy, and access to care.MethodsEnglish and Spanish-speaking adult female patients at an urban SNH breast surgical oncology clinic between August and October 2022 completed a survey assessing digital and health literacy, barriers to care, and sociodemographic information. Descriptive statistics and comparative analyses were performed using Chi-squared and Fisher’s exact tests.ResultsOf 127 invited patients, 95 (75%) completed the survey. The median age was 50 years. Fifty-six percent identified as Hispanic, 43% preferred Spanish, and 40% had less than a high school education. Health literacy was lower among Spanish-speaking, older, and less-educated patients. Digital literacy was also lower among these groups, with notable disparities in access to computers, the internet, and smartphones.ConclusionSignificant disparities in health and digital literacy exist among vulnerable breast cancer patients at SNHs, particularly among Spanish-speaking, older, and less-educated individuals. Targeted interventions to improve education, access to digital resources, and supportive services are essential to ensure equitable care and improve health outcomes for these populations.