TOPLINE

Fewer than 20% of dermatology clinic notes were viewed within 4 weeks of outpatient encounters, in a retrospective cohort study.

METHODOLOGY

• Using electronic medical record data, researchers conducted a retrospective cohort study of 57,375 outpatient general and medical dermatology visits in 2024 at an urban, tertiary academic dermatology practice in New England.
• Adults aged 18 years or older were included. The mean age was 55.0 years; 67.9% were women; 4.9% were Asian, 7% were Black, 7.4% were Hispanic, and 76.3% were White individuals.
• The primary outcome was whether patients viewed their dermatology clinic note through an electronic patient portal within 4 weeks of the visit.

TAKEAWAY

• Overall, patients viewed 18.9% of dermatology visit notes within 4 weeks. New patients were more likely to view notes than established patients (adjusted odds ratio [AOR], 1.29; 95% CI, 1.22-1.36).
• Compared with White patients, Black (AOR, 0.63; 95% CI, 0.57-0.69) and Hispanic (AOR, 0.77; 95% CI, 0.70-0.85) patients were less likely to view notes, whereas Asian patients were more likely to view notes (AOR, 1.15; 95% CI, 1.05-1.27).
• Non-English-speaking patients (vs English-speaking, AOR, 0.59; 95% CI, 0.50-0.69), male patients (vs female patients, AOR, 0.82; 95% CI, 0.78-0.85), patients of male dermatologists (vs patients of female dermatologists, AOR, 0.93; 95% CI, 0.89-0.98), and patients of experienced dermatologists (11-15 years vs 0-5 years: AOR, 0.76; 95% CI, 0.71-0.81 and 16 years or more vs 0-5 years: AOR, 0.69; 95% CI, 0.65-0.74) had lower rates of note viewing.
• The most socioeconomically disadvantaged neighborhoods (vs the least disadvantaged, AOR, 1.76; 95% CI, 1.07-2.80), insurance through Medicare (vs commercial insurance, AOR, 1.19; 95% CI, 1.11-1.27), and visits involving procedures (AOR, 1.24; 95% CI, 1.19-1.30) were associated with a higher likelihood of note viewing.

IN PRACTICE

“The study adds to limited evidence on patient engagement with dermatology documentation by identifying factors associated with post-visit note viewing and gaps in engagement and information access,” the authors wrote. “Future work should investigate longitudinal engagement patterns with dermatology notes,” and “should also assess whether note viewing is associated with treatment adherence or outcomes,” they added.

SOURCE

The study was led by Mihir K. Patil, Carle Illinois College of Medicine, University of Illinois Urbana-Champaign. It was published online as a research letter on July 8 in JAMA Dermatology.

LIMITATIONS

The study was limited by its single-center design and had limited generalizability to nonurban and nonacademic practices. Residual confounding from unmeasured differences in patient populations, dermatologist selection, visit volume, and patient-clinician relationships was possible. The 4-week follow-up captured only short-term engagement.

DISCLOSURES

One author disclosed receiving honorarium from Elsevier, McGraw-Hill, and Merck Manual outside the submitted work. No other disclosures were reported by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.