42850 Transparency in Patient Access to Dermatologic Notes

In the past decade, there have been efforts to increase healthcare transparency between patients and providers.1,2 Since research evaluating patient experiences with accessing their dermatology clinic notes is limited, we aimed to assess and improve dermatology patient experiences with viewing online medical records. An anonymous survey was offered to a weekly convenience sample of all patients presenting at two Brigham and Women’s Hospital affiliated dermatology clinics. Patients were asked about their demographic information, utilization of Patient Gateway (PG), the hospital system’s electronic patient portal, and experiences with having access to their dermatology clinic notes. Among the 359 surveys collected, 95.6% of respondents had enrolled in PG. Respondents most commonly utilized PG to view their notes (84.1%) and lab results (88.9%). Notably, no respondents reported any negative sentiment towards having access to dermatology notes. Having access to their dermatology clinic notes helped patients understand their medical condition better (70%), fostered a sense of increased involvement in their care (64.3%), and improved understanding of treatment plan (60.4%). The most common patient concerns regarding dermatology clinic notes included not understanding certain terminologies (10.4%), abbreviations (9.6%) within the notes, and missing information (6.4%). To improve the patient experience and trust in physicians, more explicit, emphatic, and supportive language should be used without compromising clinical significance. Limitations to our study include its single-institutional nature, highly educated urban demographic population, and low sample size among non-white patients, potentially impacting the generalizability of our results.