PURPOSE: To assess delays in response to patient secure e-mail messages in primary care. BACKGROUND: Secure electronic messages are initiated by primary care patients. Timely response is necessary for patient safety and quality. DATA SOURCE: A database of secure messages. SAMPLE: A random sample of 353 secure electronic messages initiated by primary care patients treated in 4 clinics. OUTCOME MEASURES: Message not opened after 12 hours or messages not responded to after 36 hours. RESULTS: A total of 8.5% of electronic messages were not opened within 12 hours, and 17.6% did not receive a response in 36 hours. Clinic location, being a clinic employee, and patient sex were not related to delays. Patients older than 50 years were more likely to receive a delayed response (25.7% delayed, P = .013). The risk of both kinds of delays was higher on weekends (P < .001 for both). CONCLUSION: The e-mail message system resulted in high rates of delayed response. Delays were concentrated on weekends (Friday-Sunday). Reducing delayed responses may require automatic rerouting of messages to message centers staffed 24-7 or other mechanisms to manage this after-hours work flow.
PURPOSE: To assess delays in response to patient secure e-mail messages in primary care. BACKGROUND: Secure electronic messages are initiated by primary care patients. Timely response is necessary for patient safety and quality. DATA SOURCE: A database of secure messages. SAMPLE: A random sample of 353 secure electronic messages initiated by primary care patients treated in 4 clinics. OUTCOME MEASURES: Message not opened after 12 hours or messages not responded to after 36 hours. RESULTS: A total of 8.5% of electronic messages were not opened within 12 hours, and 17.6% did not receive a response in 36 hours. Clinic location, being a clinic employee, and patient sex were not related to delays. Patients older than 50 years were more likely to receive a delayed response (25.7% delayed, P = .013). The risk of both kinds of delays was higher on weekends (P < .001 for both). CONCLUSION: The e-mail message system resulted in high rates of delayed response. Delays were concentrated on weekends (Friday-Sunday). Reducing delayed responses may require automatic rerouting of messages to message centers staffed 24-7 or other mechanisms to manage this after-hours work flow.
Authors: Stephanie L Shimada; Beth Ann Petrakis; James A Rothendler; Maryan Zirkle; Shibei Zhao; Hua Feng; Gemmae M Fix; Mustafa Ozkaynak; Tracey Martin; Sharon A Johnson; Bengisu Tulu; Howard S Gordon; Steven R Simon; Susan S Woods Journal: J Am Med Inform Assoc Date: 2017-09-01 Impact factor: 4.497