Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, USA.
BMC Fam Pract. 2019 May 3;20(1):57. doi: 10.1186/s12875-019-0948-1.
Patient portal secure messaging (asynchronous electronic communication between physicians and their established patients) allows patients to manage their care through asynchronous, direct communication with their providers. This type of engagement with health information technology could have important benefits for patients with chronic conditions, and a more thorough understanding of the use and barriers of secure messaging among this population is needed. The objective of this study was to explore how experienced portal users engage with secure messaging to manage their chronic conditions.
Three focus groups were conducted with 17 total patients who self-reported a cardiopulmonary condition. Participants were asked questions about their experience with patient portal secure messaging. Focus group transcripts were coded through inductive and deductive methods to reveal common themes.
Patients' motivation for using messaging included the speed and ease of such communication and direct access to a physician. Messaging was used by patients as an extension of the office visit and supported coordination of care among providers as well as patient collaboration with family members or caretakers. Patients identified challenges to using messaging, including technological barriers, worry about uncompensated physician time spent responding to messages, and confusion about what constitutes an appropriate 'non-urgent' message.
This study highlights the potential of patient portal messaging as a tool for care coordination to enhance chronic disease self-management. However, uncertainty about the appropriate use of portal messaging persists even among experienced users. Additional patient training in the proper use of secure messaging and its benefits for disease self-management may help to resolve these concerns.
患者门户安全消息传递（医生与其已建立的患者之间的异步电子通信）允许患者通过与提供者的异步直接通信来管理其护理。这种与健康信息技术的互动方式可能对慢性病患者有重要的好处，因此需要更深入地了解该人群中安全消息传递的使用情况和障碍。本研究的目的是探讨经验丰富的门户用户如何通过安全消息传递来管理其慢性病。
对 17 名自我报告患有心肺疾病的患者进行了 3 次焦点小组讨论。参与者被问及他们使用患者门户安全消息传递的经验。通过归纳法和演绎法对焦点小组的记录进行编码，以揭示共同的主题。
患者使用消息传递的动机包括这种沟通的速度和便利性，以及直接与医生联系的机会。患者将消息传递作为就诊的延伸，支持了提供者之间的护理协调，以及患者与家庭成员或护理人员的协作。患者确定了使用消息传递的挑战，包括技术障碍、担心医生回复消息会花费无报酬的时间，以及对什么构成适当的“非紧急”消息感到困惑。
本研究强调了患者门户消息传递作为增强慢性病自我管理的护理协调工具的潜力。然而，即使是经验丰富的用户，对门户消息传递的适当使用仍然存在不确定性。对安全消息传递的正确使用及其对疾病自我管理的益处进行额外的患者培训，可能有助于解决这些问题。
