Abstract
BackgroundPatient portal secure messaging (asynchronous electronic communication between physicians and their established patients) allows patients to manage their care through asynchronous, direct communication with their providers. This type of engagement with health information technology could have important benefits for patients with chronic conditions, and a more thorough understanding of the use and barriers of secure messaging among this population is needed. The objective of this study was to explore how experienced portal users engage with secure messaging to manage their chronic conditions.MethodsThree focus groups were conducted with 17 total patients who self-reported a cardiopulmonary condition. Participants were asked questions about their experience with patient portal secure messaging. Focus group transcripts were coded through inductive and deductive methods to reveal common themes.ResultsPatients’ motivation for using messaging included the speed and ease of such communication and direct access to a physician. Messaging was used by patients as an extension of the office visit and supported coordination of care among providers as well as patient collaboration with family members or caretakers. Patients identified challenges to using messaging, including technological barriers, worry about uncompensated physician time spent responding to messages, and confusion about what constitutes an appropriate ‘non-urgent’ message.ConclusionsThis study highlights the potential of patient portal messaging as a tool for care coordination to enhance chronic disease self-management. However, uncertainty about the appropriate use of portal messaging persists even among experienced users. Additional patient training in the proper use of secure messaging and its benefits for disease self-management may help to resolve these concerns.
Highlights
Patient portal secure messaging allows patients to manage their care through asynchronous, direct communication with their providers
As healthcare delivery has shifted toward patient-centered care, patient portals have become an important health information technology (HIT) that encourages patient engagement by providing access to personal health information
Motivations for using secure messaging to manage conditions Among patients with chronic health conditions, thematic analysis of focus group transcripts revealed a major theme around the motivations for using secure messaging to manage a chronic condition
Summary
Patient portal secure messaging (asynchronous electronic communication between physicians and their established patients) allows patients to manage their care through asynchronous, direct communication with their providers. This type of engagement with health information technology could have important benefits for patients with chronic conditions, and a more thorough understanding of the use and barriers of secure messaging among this population is needed. Secure messaging is one of the most frequently utilized patient portal features [17] This feature allows patients to communicate with their providers via electronic messaging (similar to email) about non-emergency questions or concerns and holds significant potential to engage patients in their care. Patients worried that messaging took up too much of their providers’ time and providers were concerned about a lack of clarity in patient messages, messages with inappropriate topics, and patients’ misunderstanding of the proper use of the messaging feature [19]
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