(A120) Examining Disparities in Patient Portal Utilization and Its Influence on Access to Pediatric Otolaryngology Care

Introduction: Direct patient-to-provider communication via electronic medical record gateway systems is rapidly expanding. However, limited research exists on who is taking advantage of such communication interfaces in pediatric surgical subspecialty settings. This study evaluates messaging patterns and outcomes within a pediatric otolaryngology practice, examining how sociodemographic factors may influence patient gateway utilization and ultimately patients’ access to care.

Methods: This retrospective study included patients aged 18 or younger presenting to a pediatric otolaryngology practice in 2023. Patients were classified as users if they or their guardians sent a message via Epic MyChart during the study period, and nonusers if the platform was not utilized. Sociodemographic and messaging data were collected, and chi-square analysis assessed differences between users and nonusers.

Results: A total of 1,864 patients visited a single, urban, pediatric otolaryngology practice in 2023. Among that group, 82 patients (4.4%) used the portal amounting to 138 separate message outreaches. Statistically significant differences were found between users and nonusers in these categories: primary language spoken (P < 0.001), commercial vs public insurance (P < 0.001), patient age (P < 0.001), race (P < 0.05), and ethnicity (P < 0.05). Of the messages sent, 17% resulted in an earlier OR or clinic date or dispensing of a new prescription, and 52% resulted in a physician or allied health personnel’s direct correspondence with the patient for counseling.

Conclusions: Our data suggests that within an economically, linguistically, and culturally diverse urban pediatric otolaryngology practice, patient gateway communications may not be equally utilized among sociodemographic groups. Portal communication enables additional interactions with care providers, sometimes leading to improved prescription access, earlier surgeries, and more frequent clinic visits. Patient portal use may be providing preferred healthcare access to English-speaking families and other historically advantaged sociodemographic groups.