Reed Mary, Graetz Ilana, Gordon Nancy, Fung Vicki
Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612. E-mail:
Am J Manag Care. 2015 Dec 1;21(12):e632-9.
To understand when patients use secure e-mail messaging with healthcare providers across several types of questions or concerns, associations between out-of-pocket costs for in-person visits and use of secure messaging, and to examine patient-reported impacts on care-seeking behavior and overall health.
Cross-sectional survey of patients in an integrated healthcare delivery system, with access to a patient portal to send secure e-mail messages to providers at no out-of-pocket cost.
The study included patients with a chronic condition (N = 1041). We described patient-reported preferences for contacting providers and patient-reported impact of e-mail use on phone calls, in-person visits, and overall health. We used multivariate analyses to examine patient characteristics associated with using e-mail as a first contact method, and effects on care-seeking and health.
Overall, 56% of patients sent their provider an e-mail within 1 year, and 46% reported e-mail as their first method of contact for 1 or more types of medical concerns. After adjustment, higher out-of-pocket costs for in-person visits were significantly associated with choosing e-mail as a first method of contact (P < .05). Among patients who had e-mailed their provider, 42% reported that it reduced their phone contacts, 36% reduced in-person office visits and 32% reported e-mailing improved their overall health.
Patients reported using e-mail broadly to initiate conversations with their providers, and patients with higher out-of-pocket costs for in-person visits were more likely to choose e-mail as a first contact method. Use of secure e-mails reduced patients' use of other types of healthcare and resulted in improved overall health.
了解患者在遇到多种类型的问题或担忧时，何时会使用安全电子邮件与医疗服务提供者沟通，当面就诊的自付费用与安全消息使用之间的关联，并研究患者报告的对寻求医疗行为和整体健康的影响。
对一个综合医疗服务提供系统中的患者进行横断面调查，这些患者可通过患者门户网站以零自付费用向医疗服务提供者发送安全电子邮件。
该研究纳入了患有慢性病的患者（N = 1041）。我们描述了患者报告的与医疗服务提供者联系的偏好，以及患者报告的电子邮件使用对电话沟通、当面就诊和整体健康的影响。我们使用多变量分析来研究与将电子邮件作为首次联系方法相关的患者特征，以及对寻求医疗和健康的影响。
总体而言，56%的患者在1年内给他们的医疗服务提供者发送了电子邮件，46%的患者报告电子邮件是他们针对1种或多种医疗问题的首选联系方法。经过调整后，当面就诊的较高自付费用与选择电子邮件作为首选联系方法显著相关（P <.05）。在给医疗服务提供者发送过电子邮件的患者中，42%的患者报告这减少了他们的电话联系，36%的患者减少了当面就诊次数，32%的患者报告电子邮件改善了他们的整体健康。
患者报告广泛使用电子邮件与医疗服务提供者展开对话，当面就诊自付费用较高的患者更有可能选择电子邮件作为首选联系方法。使用安全电子邮件减少了患者对其他类型医疗服务的使用，并改善了整体健康。
