Heisey-Grove Dawn, Rathert Cheryl, McClelland Laura E, Jackson Kevin, DeShazo Jonathan
Promoting Health and Disease Prevention Department, Public Health Division, The Health FFRDC The MITRE Corporation McLean Virginia.
Health Administration Department College of Health Professions, Virginia Commonwealth University Richmond Virginia.
Health Sci Rep. 2021 May 24;4(2):e295. doi: 10.1002/hsr2.295. eCollection 2021 Jun.
As secure electronic message exchange increases between patients and clinicians, we must explore and understand how patients and clinicians use those messages to communicate between clinical visits.
To present the application of a taxonomy developed specifically to code secure message content in a way that allows for identification of patient and clinician communication functions demonstrated to be associated with patients' intermediate and health outcomes.
We randomly sampled 1031 patients who sent and received 18 309 messages and coded those messages with codes from our taxonomy. We present the prevalence of each taxon (ie, code) within the sample.
The most common taxon among initial patient-generated messages were (29.09%), followed by (27.91%), and (23.09%). Over half of subsequent patient-generated messages included responses to clinic staffs' questions (58.31%). Six in 10 clinic staff responses included some form of Information sharing with process-based responses being most common (32.81%). A third of all clinician-generated messages (36.28%) included acknowledgement or some level of fulfilment of a patient's task-oriented request. Clinic staff sought information from patients in 20.54% of their messages.
This taxonomy is the first step toward examining whether secure messaging communication can be associated with patients' health outcomes. Knowing which content is positively associated with outcomes can support training of, and targeted responses from, clinicians with the goal of generating message content designed to improve outcomes.
This study is based on analyses of patient-initiated secure message threads.
随着患者与临床医生之间安全电子信息交换的增加，我们必须探索并理解患者和临床医生如何利用这些信息在门诊就诊期间进行沟通。
介绍一种专门开发的分类法的应用，该分类法以一种能够识别已证明与患者的中期和健康结局相关的患者和临床医生沟通功能的方式对安全信息内容进行编码。
我们随机抽取了1031名收发了18309条信息的患者，并使用我们分类法中的编码对这些信息进行编码。我们展示了样本中每个分类单元（即编码）的流行情况。
患者最初生成的信息中最常见的分类单元是（29.09%），其次是（27.91%），以及（23.09%）。超过一半的患者后续生成的信息包括对诊所工作人员问题的回复（58.31%）。十分之六的诊所工作人员回复包括某种形式的信息共享，基于流程的回复最为常见（32.81%）。所有临床医生生成的信息中有三分之一（36.28%）包括对患者面向任务的请求的确认或某种程度的满足。诊所工作人员在20.54%的信息中向患者寻求信息。
这种分类法是迈向检验安全信息通信是否可与患者健康结局相关联的第一步。了解哪些内容与结局呈正相关可以支持对临床医生的培训以及他们有针对性的回复，目标是生成旨在改善结局的信息内容。
本研究基于对患者发起的安全信息线程的分析。
