Joy L Lee1,2, Marianne S Matthias1,2,3, Monica Huffman2, Richard M Frankel1,2,3, Michael Weiner1,2,3. 1. Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. 2. Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, Indiana, USA. 3. Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.
Abstract
OBJECTIVE: Secure messaging has become an integrated function of patient portals, but misuse of secure messaging by both patients and clinicians can lead to miscommunication and errors, such as overlooked urgent messages. We sought to uncover variations in clinician approaches and responses to messaging with patients. METHODS: In this two-part study, 20 primary care clinicians (1) composed message responses to five hypothetical patient vignettes and messages and (2) were subsequently interviewed for their perspectives on appropriate circumstances for secure messaging. Messages and interviews were analyzed for themes. RESULTS: Clinicians have different experiences with, and perceptions of, secure messaging. The messages the clinicians wrote were uniformly respectful, but differed in degrees of patient-centeredness and level of detail. None of the clinicians found their messaging workload to be unmanageable. From the interviews, we found divergent clinician perspectives about when to use secure messaging and how to respond to emotional content. CONCLUSION: Clinicians have different opinions about the appropriateness of secure messaging in response to specific medical issues. Our results noted a desire and need for greater guidance about secure messaging. This aspect of informatics education warrants greater attention in clinical practice. PRACTICAL IMPLICATIONS: We summarize the types of issues raised by the participants yet to be addressed by existing guidelines. Further guidance from hospitals, professional societies, and other institutions that govern clinician behavior on the appropriateness and effectiveness of delivering care through secure messaging may aid clinicians and patients.
OBJECTIVE: Secure messaging has become an integrated function of patient portals, but misuse of secure messaging by both patients and clinicians can lead to miscommunication and errors, such as overlooked urgent messages. We sought to uncover variations in clinician approaches and responses to messaging with patients. METHODS: In this two-part study, 20 primary care clinicians (1) composed message responses to five hypothetical patient vignettes and messages and (2) were subsequently interviewed for their perspectives on appropriate circumstances for secure messaging. Messages and interviews were analyzed for themes. RESULTS: Clinicians have different experiences with, and perceptions of, secure messaging. The messages the clinicians wrote were uniformly respectful, but differed in degrees of patient-centeredness and level of detail. None of the clinicians found their messaging workload to be unmanageable. From the interviews, we found divergent clinician perspectives about when to use secure messaging and how to respond to emotional content. CONCLUSION: Clinicians have different opinions about the appropriateness of secure messaging in response to specific medical issues. Our results noted a desire and need for greater guidance about secure messaging. This aspect of informatics education warrants greater attention in clinical practice. PRACTICAL IMPLICATIONS: We summarize the types of issues raised by the participants yet to be addressed by existing guidelines. Further guidance from hospitals, professional societies, and other institutions that govern clinician behavior on the appropriateness and effectiveness of delivering care through secure messaging may aid clinicians and patients.
Authors: Mary Catherine Beach; Debra Roter; Haya Rubin; Richard Frankel; Wendy Levinson; Daniel E Ford Journal: J Gen Intern Med Date: 2004-09 Impact factor: 5.128
Authors: Joy L Lee; Marianne S Matthias; Nir Menachemi; Richard M Frankel; Michael Weiner Journal: J Am Med Inform Assoc Date: 2018-04-01 Impact factor: 4.497
Authors: Caroline Lubick Goldzweig; Greg Orshansky; Neil M Paige; Ali Alexander Towfigh; David A Haggstrom; Isomi Miake-Lye; Jessica M Beroes; Paul G Shekelle Journal: Ann Intern Med Date: 2013-11-19 Impact factor: 25.391
Authors: Stephanie L Shimada; Jeroan J Allison; Amy K Rosen; Hua Feng; Thomas K Houston Journal: J Med Internet Res Date: 2016-07-01 Impact factor: 5.428
Authors: Jordan M Alpert; Chelsea N Hampton; Aantaki Raisa; Merry Jennifer Markham; Carma L Bylund Journal: Support Care Cancer Date: 2022-10-19 Impact factor: 3.359