An analysis of patient-provider secure messaging at two Veterans Health Administration medical centers: message content and resolution through secure messaging

• DOI: 10.1093/jamia/ocx021
• Publication Date: 2017-02-24T20:10:20Z
• 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
• Keywords: Veterans Affairs; Text Messaging

We sought to understand how patients and primary care teams use secure messaging (SM) communicate with one another by analyzing message threads from 2 Department of Veterans Affairs facilities.We coded 1000 SM communication sampled 40 teams.Most (94.5%) were initiated (90.4%) or caregivers (4.1%); only 5.5% team members proactively reaching out patients. Medication renewals refills (47.2%), scheduling requests (17.6%), medication issues (12.9%), health (12.7%) the most common patient-initiated requests, followed referrals (7.0%), administrative (6.5%), test results (5.4%), (5.2%), informing messages (4.9%), comments about patient portal (4.1%), appreciation (3.9%), self-reported data (2.8%), life (1.5%), complaints (1.5%). Very few clinically urgent (0.7%) contained other potentially challenging content. Message mostly short (2.7 messages), comprising an average 1.35 discrete content types. A substantial proportion (24.2%) did not show any evidence being resolved through SM. Time response extent resolution via varied Proactive varied, but was often for (32.7%), medication-related (21.8%), (16.4%), (18.2%).The majority transactional caregivers. Not all categories fully addressed over Further education training both clinical could improve quality efficiency communication.