Patient-Provider Secure Messaging in VA

Shimada, Stephanie L.; Hogan, Timothy P.; Rao, Sowmya R.; Allison, Jeroan J.; Quill, Ann L.; Feng, Hui; Phillips, Barrett D.; Nazi, Kim M.; Haidary, Susan T.; Houston, Thomas K.

doi:10.1097/mlr.0b013e3182780917

Cited by 45 publications

(21 citation statements)

References 13 publications

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“…Studies from 2013 also demonstrated several barriers to use of the patient portal; most common were lack of Internet access and lack of technical support [19,20,22,23]. Another significant finding in 2013 was the association of patient portal use with medication adherence, disease control, self-maintenance of health, and including the patient in the medical decision [16,19,22,23].…”

Section: Resultsmentioning

confidence: 99%

“…Another significant finding in 2013 was the association of patient portal use with medication adherence, disease control, self-maintenance of health, and including the patient in the medical decision [16,19,22,23]. …”

Section: Resultsmentioning

confidence: 99%

“…In contrast, this review identified several clinical and administrative improvements that qualify as quality, as defined by the AHRQ and HRSA, but our review did not include any RCTs. Improvements were identified in medication adherence and the management of chronic disease [5,9,13,22], disease awareness [33], improved self-care [19,22], general “clinically relevant benefits” [13], and a decrease in the number of office visits [33]. Use of the patient portal also increased customer retention [29], which is related to continuity of care.…”

Section: Discussionmentioning

confidence: 99%

“…Use of the patient portal also increased customer retention [29], which is related to continuity of care. The use of the patient portal was also associated with extended office visits to ask questions of the providers, and an increase in preventative medicine [19]. Although each article talked about application features related to Meaningful Use, only one study specifically used the term [24].…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review

Kruse¹,

Bolton²,

Freriks³

2015

J Med Internet Res

340

258

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BackgroundThe Health Information Technology for Economic and Clinical Health (HITECH) Act imposes pressure on health care organizations to qualify for “Meaningful Use”. It is assumed that portals should increase patient participation in medical decisions, but whether or not the use of portals improves outcomes remains to be seen.ObjectiveThe purpose of this systemic review is to outline and summarize study results on the effect of patient portals on quality, or chronic-condition outcomes as defined by the Agency for Healthcare Research and Quality, and its implications to Meaningful Use since the beginning of 2011. This review updates and builds on the work by Ammenwerth, Schnell-Inderst, and Hoerbst.MethodsWe performed a systematic literature search in PubMed, CINAHL, and Google Scholar. We identified any data-driven study, quantitative or qualitative, that examined a relationship between patient portals, or patient portal features, and outcomes. We also wanted to relate the findings back to Meaningful Use criteria. Over 4000 articles were screened, and 27 were analyzed and summarized for this systematic review.ResultsWe identified 26 studies and 1 review, and we summarized their findings and applicability to our research question. Very few studies associated use of the patient portal, or its features, to improved outcomes; 37% (10/27) of papers reported improvements in medication adherence, disease awareness, self-management of disease, a decrease of office visits, an increase in preventative medicine, and an increase in extended office visits, at the patient’s request for additional information. The results also show an increase in quality in terms of patient satisfaction and customer retention, but there are weak results on medical outcomes.ConclusionsThe results of this review demonstrate that more health care organizations today offer features of a patient portal than in the review published in 2011. Articles reviewed rarely analyzed a full patient portal but instead analyzed features of a portal such as secure messaging, as well as disease management and monitoring. The ability of patients to be able to view their health information electronically meets the intent of Meaningful Use, Stage 2 requirements, but the ability to transmit to a third party was not found in the review.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review

Kruse¹,

Bolton²,

Freriks³

2015

J Med Internet Res

340

258

View full text Add to dashboard Cite

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“…Health systems must allot providers enough time to address patient needs that arise electronically and consider incorporating a team-based workflow into secure electronic messaging. It is also unclear how secure electronic messaging will affect face-to-face visits in a safety-net setting given that prior studies demonstrate mixed impacts on in-person utilization (Bergmo, Kummervold, Gammon, & Dahl, 2005;Liss et al, 2014;Palen, Ross, Powers, & Xu, 2012;Shimada et al, 2013;Zhou, Garrido, Chin, Wiesenthal, & Liang, 2007). Finally, given the increasingly broad adoption of this medium across the United States, more studies are needed in varying care settings to elucidate the factors influencing utilization and content of electronic communication.…”

Section: Practical Implicationsmentioning

confidence: 99%

A Mixed-Methods Study of Patient–Provider E-Mail Content in a Safety-Net Setting

Mirsky

Tieu

Lyles

et al. 2015

Journal of Health Communication

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Objective-To explore the content of patient-provider e-mails in a safety-net primary care clinic.Methods-We conducted a content analysis using inductive and deductive coding of e-mail exchanges (n=31) collected from January through November of 2013. Participants were Englishspeaking adult patients with a chronic condition (or their caregivers) cared for at a single publiclyfunded general internal medicine clinic and their primary care providers (attending general internist physicians, clinical fellows, internal medicine residents, and nurse practitioners).Results-All e-mails were non-urgent. Patients included a medical update in 19% of all e-mails. Patients requested action in 77% of e-mails, and the most common requests overall were for action regarding medications or treatment (29%). Requests for information were less common (45% of emails). Patient requests (n=56) were resolved in 84% of e-mail exchanges, resulting in 63 actions.Conclusion-Patients in safety-net clinics are capable of safely and effectively using electronic messaging for between-visit communication with providers.Practical Implications-Safety-net systems should implement electronic communications tools as soon as possible to increase healthcare access and enhance patient involvement in their care.

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Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions in the United States From 2008 to 2015

2018

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IMPORTANCE Over the past 2 decades, a variety of new care options have emerged for acute care, including urgent care centers, retail clinics, and telemedicine. Trends in the utilization of these newer care venues and the emergency department (ED) have not been characterized.OBJECTIVE To describe trends in visits to different acute care venues, including urgent care centers, retail clinics, telemedicine, and EDs, with a focus on visits for treatment of low-acuity conditions. DESIGN, SETTING, AND PARTICIPANTSThis cohort study used deidentified health plan claims data from Aetna, a large, national, commercial health plan, from January 1, 2008, to December 31, 2015, with approximately 20 million insured members per study year. Descriptive analysis was performed for health plan members younger than 65 years. Data analysis was performed from December 28, 2016, to February 20, 2018 MAIN OUTCOMES AND MEASURES Utilization, inflation-adjusted price, and spending associated with visits for treatment of low-acuity conditions. Low-acuity conditions were identified using diagnosis codes and included acute respiratory infections, urinary tract infections, rashes, and musculoskeletal strains. RESULTSThis study included 20.6 million acute care visits for treatment of low-acuity conditions over the 8-year period. Visits to the ED for the treatment of low-acuity conditions decreased by 36%

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Patient-Provider Secure Messaging in VA

Abstract: In this exploratory analysis of early SM implementation in VA, we found a path of associations linking SM and reductions in UC utilization. These results suggest a need for further examination of the relationship between SM and its effects on health care utilization patterns.

Cited by 45 publications

References 13 publications

The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review

The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review

A Mixed-Methods Study of Patient–Provider E-Mail Content in a Safety-Net Setting

Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions in the United States From 2008 to 2015

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