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Physicians, patients need more training on secure electronic messaging

Secure electronic messaging can help patients be better informed about their healthcare and improve access to healthcare providers, but the authors of a new study say more education is needed to improve the quality and efficiency of secure communication.

Researchers analyzed 1,000 threads – defined as strings of related messages – from two Department of Veterans Affairs (VA) facilities. Patients initiated an overwhelming majority of threads (90.4%), while caregivers began 4.1% of threads on behalf of a patient. Primary care team members initiated 5.5% of threads.

Patients and clinicians also used secure electronic messaging for different purposes.

Patients most often initiated messages to ask for a medication renewal or refill (47.2%). Patients also used secure messaging for scheduling requests (17.6%), medication issues (12.9%) and health issues (12.7%).

The majority of clinician-initiated threads (32.7%) were sent to report test results, followed by medication issues (21.8%), scheduling issues (18.2%) and medication renewals (16.4%).

Although some providers have expressed concern that patients would use secure electronic messaging for urgent medical issues, the researchers found that only 0.7% of patient-initiated messages contained content deemed clinically urgent.

Overall, patients viewed the use of secure messaging as an alternative to unnecessary in-person visits. It was also convenient and enabled easy, round-the-clock access to clinicians. Secure messaging also enabled patients to discuss potentially embarrassing topics.

The authors of the study, which was published in the Journal of the American Medical Informatics Association, concluded that both patients and clinicians could benefit from further education and training on the uses of secure electronics messaging. Most current guidelines for secure messaging focus on the technical and administrative areas, and not the potential use cases.