E-mail Access and Improved Communication Between Patient and Surgeon

Stålberg, Peter; Yeh, Michael W.; Ketteridge, Geraldine; Delbridge, Hilary; Delbridge, Leigh

doi:10.1001/archsurg.2007.31

Cited by 18 publications

(7 citation statements)

References 15 publications

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“…Similar variability across specialties has been demonstrated previously for medical specialties at our institution and others [25, 41]. Many factors likely influence the number of messages received by a specialty, including outpatient clinic encounter volume, provider comfort with technology and clinic workflow [10, 27–29], encouragement or discouragement of providers [3, 30], promotion of messaging to patients [3, 12, 30], the duration and frequency of follow-up perioperatively, patients’ clinical needs, and patient demographics and sociotechnical factors [31, 32]. The unique message triage process at our institution, including the ability for each department to set its own workflow and staffing practices, may also have contributed to the differences observed.…”

Section: Discussionsupporting

confidence: 70%

“…Secure messaging can deliver clinical care that is complementary to traditional outpatient encounters [11, 17, 18], increase frequency of communication between patients and providers [19], and enable providers to better know their patients [19]. Patients may also feel empowered and safe to discuss questions or concerns through messaging that they would not bring up during an office visit [12, 17]. Studies within primary care or medicine specialty practices demonstrated the potential for secure messaging to improve health outcomes [20] while reducing healthcare system costs and resource utilization [21, 22].…”

Section: Introductionmentioning

confidence: 99%

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Rapid growth in surgeons’ use of secure messaging in a patient portal

et al. 2015

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Background Use of secure messaging through patient portals has risen substantially in recent years due to provider incentives and consumer demand. Secure messaging may increase patient satisfaction and improve outcomes, but also adds to physician workload. Most prior studies of secure messaging focused on primary care and medical specialties. We examined surgeons’ use of secure messaging and the contribution of messaging to outpatient interactions in a broadly-deployed patient portal. Methods We determined the number of clinic visits and secure messages for surgical providers in the first three years (2008–10) after patient portal deployment at an academic medical center. We calculated the proportion of outpatient interaction conducted through messaging for each specialty. Logistic regression models compared the likelihood of message-based versus clinic outpatient interaction across surgical specialties. Results Over the study period, surgical providers delivered care in 648,200 clinic visits and received 83,912 messages, with more than 200% growth in monthly message volume. Surgical specialties receiving the most messages were orthopedics/podiatry (25.1%), otolaryngology (20.1%), urology (10.8%), and general surgery (9.6%); vascular surgery (0.8%) and pediatric general surgery (0.2%) received the fewest. The proportion of outpatient interactions conducted through secure messaging increased significantly from 5.4% in 2008 to 15.3% in 2010 (p<0.001) with all specialties experiencing growth. Heart/lung transplantation (74.9%), liver/kidney/pancreas transplantation (69.5%), and general surgery (48.7%) had the highest proportion of message-based outpatient interaction by the end of the study. Conclusions This study demonstrates rapid adoption of online secure messaging across surgical specialties with significant growth in its use for outpatient interaction. Some specialties, particularly those with long-term follow-up, interacted with patients more through secure messaging than in person. As surgeons devote more time to secure messaging, additional research will be needed to understand the care delivered through online interactions and to develop models for reimbursement.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Rapid growth in surgeons’ use of secure messaging in a patient portal

et al. 2015

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“…Under the PCMH principles, enhanced access to care should be available through new options for communication between patients, their personal physician, and practice staff, including those that link providers and patients outside of the traditional office visit. For example, e-mail communication has been found to be a more convenient form of communication that increases satisfaction among patients (Leong et al 2005;Rosen and Kwoh 2007;Stalberg et al 2008;Ye et al 2010). The importance of out-of-office contact is supported by the fact that approximately one-fifth of U.S. adults reported that they do not get "enough time" with their physician during an office visit (Kaiser Family Foundation 2005) and almost half of them said that they had difficulty in understanding instructions they received from the physician's office (The Commonwealth Fund 2002).…”

Section: Out-of-office Contactmentioning

confidence: 99%

The Patient‐Centered Medical Home and Patient Experience

Martsolf

Alexander

Shi

et al. 2012

Health Services Research

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“…Because of its pervasiveness and relative ease of use, electronic mail (email) offers a potentially valuable resource for augmenting and improving communication between physicians and patients [1]. Even so, email communication remains an untapped resource in health care [2].…”

Section: Introductionmentioning

confidence: 99%

Older Patients’ Enthusiasm to Use Electronic Mail to Communicate With Their Physicians: Cross-Sectional Survey

Singh¹,

Fox²,

Petersen³

et al. 2009

J Med Internet Res

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Background Recent evidence indicates increased access to and use of Internet and non-healthcare-related email by older patients. Because email adoption could potentially reduce some of the disparities faced by this age group, there is a need to understand factors determining older patients’ enthusiasm to use email to communicate with their physicians. Electronic mail (email) represents a means of communication that, coupled with face-to-face communication, could enhance quality of care for older patients.Objective Test a model to determine factors associated with older patients’ enthusiasm to use email to communicate with their physicians.Methods We conducted a secondary data analysis of survey data collected in 2003 for two large, longitudinal, randomized controlled trials. Logistic-regression models were used to model the dichotomous outcome of patient enthusiasm for using email to communicate with their physicians. Explanatory variables included demographic characteristics, health status, use of email with people other than their physician, characteristics of the physician-patient relationship, and physician enthusiasm to use email with patients.Results Participants included a pooled sample of 4059 patients over 65 years of age and their respective physicians (n = 181) from community-based practices in Southern California. Although only 52 (1.3%) patient respondents reported that they communicated with their physician by email, about half (49.3%) expressed enthusiasm about the possibility of using it. Odds of being enthusiastic decreased with increased age (by 0.97 for each year over 66) but were significantly higher in African Americans (OR = 2.1, CI = 1.42 - 3.06), Hispanics (OR = 1.6, CI = 1.26 - 2.14) and men (OR = 1.3, CI = 1.1 - 1.5).A perception of better communication skills of their physician, lower quality of interaction with physician in traditional face-to-face encounters, and physician enthusiasm to use email with patients were significantly associated with an enthusiasm to use email. Patients who did not use email at all were less enthusiastic compared to those who used email for other reasons. Half of the physician respondents were not enthusiastic about communicating with patients using email.Conclusions Despite perceived barriers such as limited access to the Internet, older patients seem to want to use email to communicate with their physicians.

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E-mail Access and Improved Communication Between Patient and Surgeon

Abstract: Despite concerns about potential medicolegal issues and other disadvantages, providing patients undergoing elective surgery with e-mail access to their surgeon results in improved levels of communication without any demonstrated impairment of satisfaction with outcomes.

Cited by 18 publications

References 15 publications

Rapid growth in surgeons’ use of secure messaging in a patient portal

Rapid growth in surgeons’ use of secure messaging in a patient portal

The Patient‐Centered Medical Home and Patient Experience

Older Patients’ Enthusiasm to Use Electronic Mail to Communicate With Their Physicians: Cross-Sectional Survey

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