Insights and Trends in Open Note Access: Retrospective Observational Study

Area of Science:

• Health Informatics
• Patient Engagement
• Digital Health

Background:

• Increasing patient portal adoption for clinical note access, driven by legislation like the 21st Century Cures Act.
• Limited data exists on evolving open note usage patterns and popular clinical interaction types in outpatient settings.

Purpose of the Study:

• Analyze trends in outpatient open note access over time.
• Characterize patient portal usage by demographics and clinical interaction type.
• Assess access methods to identify areas for improving patient engagement and future research.

Main Methods:

• Retrospective observational study of outpatient note access logs from November 2021 to December 2022.
• Data included 18,384 note accesses by 4,615 users, analyzing patient demographics, note titles, access times, and methods (web vs. mobile).
• Microsoft Excel and Power Query were utilized for data compilation and analysis.

Main Results:

• Only 13.1% of portal registrants accessed outpatient notes, with a female predominance (63.4%).
• Users in their 30s and 50s accessed notes most frequently; COVID-19 assessments were the most viewed notes (38.9%).
• Mobile access decreased with age, highlighting the importance of web access for older populations; user engagement peaked early and declined.

Conclusions:

• Open note access peaked during COVID-19, driven by related assessments, and declined as the pandemic waned.
• Female patients and those in their 30s and 50s were more frequent users of open notes.
• Web-based access is crucial for older adults, as mobile access diminishes with increasing age.