Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, California, USA.
Center for Vulnerable Populations, University of California, San Francisco, San Francisco, California, USA.
J Am Med Inform Assoc. 2021 Jun 12;28(6):1252-1258. doi: 10.1093/jamia/ocaa281.
The substantial expansion of secure messaging (SM) via the patient portal in the last decade suggests that it is becoming a standard of care, but few have examined SM use longitudinally. We examined SM patterns among a diverse cohort of patients with diabetes (N = 19 921) and the providers they exchanged messages with within a large, integrated health system over 10 years (2006-2015), linking patient demographics to SM use. We found a 10-fold increase in messaging volume. There were dramatic increases overall and for patient subgroups, with a majority of patients (including patients with lower income or with self-reported limited health literacy) messaging by 2015. Although more physicians than nurses and other providers messaged throughout the study, the distribution of health professions using SM changed over time. Given this rapid increase in SM, deeper understanding of optimizing the value of patient and provider engagement, while managing workflow and training challenges, is crucial.
在过去十年中，通过患者门户进行安全消息传递（SM）的大幅扩展表明它正在成为一种护理标准，但很少有人对 SM 的使用进行纵向研究。我们在一个大型综合医疗系统中，对 19921 名患有糖尿病的患者和他们与之交流的提供者进行了研究，对他们的 SM 使用模式进行了研究，该系统跨越了 10 年（2006-2015 年），将患者人口统计学信息与 SM 使用相关联。我们发现消息数量增加了 10 倍。总体而言，所有患者亚组的消息数量都大幅增加，到 2015 年，大多数患者（包括收入较低或自报健康素养有限的患者）都在使用 SM。尽管在整个研究过程中，医生比护士和其他提供者发送的消息更多，但使用 SM 的卫生专业人员的分布随着时间的推移而发生了变化。鉴于 SM 的快速增长，深入了解如何优化患者和提供者参与的价值，同时管理工作流程和培训挑战至关重要。
