O3196: Pediatric EPIC MyChart usage among Spanish speaking patients, does language matter?

Background: Language barriers contribute to disparities in access to care. Children living in households where English is not the primary language have, on average, more unmet medical needs than children who are English speakers. Patient portals (e.g., MyChart) enable patients to view their medical records as well as to asynchronously communicate with their medical teams. However, information within portals is predominantly presented in English. Our aim is to compare the care-seeking behaviors among Spanish-speaking patients who use the portal versus those who do not.

Methods: We conducted an observational retrospective study which included all patients younger than 18 years old, who had ≥1ambulatory pediatric visit at a large-integrated health system between January 2020 and December 2022. We focused the analysis on patients who identified “Spanish-speaking” as their “preferred language” in our EHR. Data regarding MyChart usage, compliance with well-child care visits, health characteristics and emergency department visits were collected. “Up-to-date” well-child care visits and immunizations are based on AAP and ACIP/CDC recommendations for age. We classified patients as a “MyChart user” if they sent at least 1 message after account activation and during the study timeframe. We used descriptive statistics (Fisher’s exact tests and Students t-tests) to compare demographic, health, and utilization characteristics between Spanish-speaking MyChart users and non-users. A logistic regression model accounting for age, insurance, Asthma, and ADHD diagnosis was used to identify the association between MyChart usage and being up to date with well-child visits. Index visit was defined as the closest visit after MyChart activation for users and a randomly selected visit for non-MyChart users.

Results: Our sample included 84,476 patients. Of these, 75% (n=62944) were MyChart users. One percent of the MyChart users and non-MyChart users were predominantly Spanish speaking (n=517 versus n=226, p< 0.01). Of Spanish-speaking patients, the majority had Medicaid insurance (89% MyChart users versus 88% non-users). The average age of MyChart users was similar to non-users (5.7 versus 6.9 years, p=0.18), and a similar percentage identified as Hispanic (92% versus 88%, p=0.09) and had a diagnosis for Asthma (20% versus 16%, p=0.16) or ADHD (12% versus 8.4%, p=0.17). MyChart users had higher compliance with well-child visits (74% versus 32%, p< 0.01), and a lower percentage, had 3 or more ED visits in the 12-months after the index visit (4.1% versus 9.7%, p< 0.01). In the adjusted models, MyChart users had greater odds of well-child visits (AOR: 6.20, 95%CI: 4.36, 8.91).

Conclusion: Our results show higher preventive care measures in Spanish-speaking MyChart users. Understanding the barriers to MyChart usage and addressing them may improve its usage and potentially uptake of preventive health care.