Understanding Primary Care Physicians' Comprehension of Eye Care Notes to Improve Diabetes Care Coordination

Diabetic retinopathy screening and management involve collaboration between primary care providers (PCPs), endocrinologists, and eye care providers, yet eye care documentation poses challenges to inter-specialty communication.

To assess PCP and endocrinologist comprehension of ophthalmology notes, identify barriers to interpretation, and identify strategies for improvement.

We conducted a cross-sectional online survey of 82 PCPs and endocrinologists across three academic tertiary health systems between November 2022 and December 2024. The survey collected demographic data, prior rotations in ophthalmology, and self-reported comprehension of components of eye care notes using 5-point Likert scales. 67 participants reviewed three sample eye care progress notes and identified whether a dilated fundus examination was performed and the presence of diabetic retinopathy for each note. Free-text responses were analyzed thematically.

Self-reported comprehension of eye care documentation was modest: 47% agreed and 6% strongly agreed that they generally understand eye care notes. Comprehension of sample notes similarly varied, with correct identification of dilation status ranging from 94-96% and diabetic retinopathy status from 37-82%. 29% of respondents who answered fewer than half of the questions correctly reported confidence in their general understanding of eye care notes. Major barriers to inter-specialty care coordination for patients with diabetes included inconsistent coding and formatting and use of ophthalmology-specific jargon and abbreviations.

PCPs and endocrinologists demonstrated variable confidence in their comprehension of eye care documentation, with measurable gaps in interpreting key clinical elements of notes. More standardized and structured documentation may improve inter-specialty communication and coordination of care for patients with diabetes.