Large-Scale Survey Findings Inform Patients' Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment.
Large-Scale Survey Findings Inform Patients' Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment.
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DOI：
10.2196/jmir.5152
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发表时间：
2015-12-21
影响因子：
7.4
通讯作者：
Antinori, Nicole
中科院分区：
文献类型：
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作者：
Haun, Jolie N;Patel, Nitin R;Antinori, Nicole
背景：安全电子邮件是美国一项国家转型计划的一部分，该计划旨在推广支持加强患者与提供者沟通的新护理模式。到目前为止，只有有限数量的大型研究评估了用户使用安全电子邮件传递的体验。目的：定量评估退伍军人患者在大样本患者中使用安全电子邮件传递的体验。方法：对注册到退伍军人健康管理局基于Web的患者门户网站(My HealtheVet)并选择使用安全电子邮件传递的受访者进行了横断面邮递纸笔调查研究。这项调查收集了人口统计数据，评估了计算机和健康素养，以及安全信息使用。对调查数据进行分析，包括频率和比例、卡方检验和单因素方差分析。结果：大多数受访者(N=819)报告使用安全短信6个月或更长时间(n=499，60.9%)。他们报告说，安全信息有助于完成药物补充(n=546，66.7%)、管理预约(n=343，41.9%)、查看测试结果(n=350，42.7%)和询问与健康相关的问题(n=340，41.5%)。值得注意的是，一些受访者报告使用安全消息传递来解决敏感的健康问题(n=67，8.2%)。调查结果表明，较年轻的年龄(P=.039)、较高的教育水平(P=.025)和较高的收入(P=.003)与更频繁地使用安全信息有关。与男性相比，女性更有可能报告更频繁地使用安全消息(P=.098)。与非少数民族相比，少数族裔更有可能报告更频繁地使用安全消息传递，至少每月一次(P=.086)。与健康素养较低的人相比，健康素养水平较高的人报告更频繁地使用安全消息传递(P=0.007)，满意度更高(P=0.002)，并表示安全消息传递是一种有用的(P=0.002)和易于使用(P≤.001)的沟通工具。许多受访者(n=328，40.0%)报告说，他们希望接受教育和/或认为其他退伍军人将从如何访问和使用电子患者门户以及安全消息传递的教育中受益(n=652，79.6%)。结论：调查结果证实了先前研究中发现的定性结果，即退伍军人认为安全电子邮件消息传递是与医疗团队沟通的有用工具。为了最大限度地提高安全电子邮件消息的持续利用率，需要营销、培训、技能培养和系统修改。这些发现可以为正在进行的努力提供信息，以促进这种电子工具的持续使用，以支持患者与提供者的沟通。
BACKGROUND: Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users' experiences in using secure email messaging.OBJECTIVE: To quantitatively assess veteran patients' experiences in using secure email messaging in a large patient sample.METHODS: A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations' Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance.RESULTS: The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy-to-use (P≤.001) communication tool, compared with individuals with lower reported health literacy. Many respondents (n=328, 40.0%) reported that they would like to receive education and/or felt other veterans would benefit from education on how to access and use the electronic patient portal and secure messaging (n=652, 79.6%).CONCLUSIONS: Survey findings validated qualitative findings found in previous research, such that veterans perceive secure email messaging as a useful tool for communicating with health care teams. To maximize sustained utilization of secure email messaging, marketing, education, skill building, and system modifications are needed. These findings can inform ongoing efforts to promote the sustained use of this electronic tool to support for patient-provider communication.