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Patients Message Providers More When Providers Reach Out

Posted on April 26, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that patients use secure electronic messaging more when their primary care providers initiate and respond to secure messages.

To conduct the study, the research team worked a large database stocked with information on health care transactions and secure messaging records on 81,645 US Army soldiers. The data also included information from almost 3,000 clinicians with access to a patient portal system. The dataset encompassed the 4-year period between January 2011 and November 2014.

The data, which appears in a paper published in the Journal of Medical Internet Research, suggests that current provider-patient exchanges via secure messaging aren’t that common. For example, during the study period just 7 percent of patients initiated a secure message during a given month. Meanwhile, Providers initiated an average of 0.007 messages per patient each month, while responding to 0.09 messages per patient during a month.

That being said, when physicians got more engaged with the messaging process, patients responded dramatically.

Patients who knew their providers were responsive initiated a whopping 334 percent more secure messages than their baseline. Even among patients whose providers responded infrequently to their messages, the level at which they initiated messages to their clinicians was 254 percent higher than with PCPs who weren’t responding. (Oddly, when PCP response rates were at the “medium” level, patients increased messaging by 167 percent.)

In fact, when clinicians communicated more, there seemed to be spillover effects. Specifically, the researchers found that patients messaged PCPs more if that provider was very responsive to other patients, suggesting that there’s a network effect in play here.

Meanwhile, when PCPs were the ones prone to initiating messages, patients were 60 percent more likely to send a secure message. In other words, patients were more energized by PCP responses than clinician-initiated messages.

Of course, for secure messaging to have any real impact on care quality and outcomes, a critical mass of patients need to use messaging tools. Historically, though, providers have struggled to get patients to use their portal, with usage levels hovering between 10 percent and 32 percent.

Usage rates for portals have stayed stubbornly low even when doctors work hard to get their patients interested. Even patients who have signed up to use the portal often don’t follow through, research suggests. And of course, patients who don’t touch the portal aren’t exchanging care-enhancing messages with their provider.

If we’re going to get patients to participate in messaging with their doctor, we’re going to have to admit that the features offered by basic portals simply aren’t that valuable. While most offer patients access to some details of their medical records and test results, and sometimes allow them to schedule appointments, many don’t provide much more.

Meanwhile, a surprising number of providers haven’t even enabled a secure messaging function on their portal, which confines it to being a sterile data receptacle. I’d argue that without offering this feature, portals do almost nothing to engage their typical patient.

Of course, physicians fear being overwhelmed by patient messages, and reasonably fear that they won’t have time to respond adequately. Even though many organizations including the research of Dr. CT Lin has shown this just isn’t the case. That being said, if they want to increase patient engagement – and improve their overall health – secure messaging is one of the simplest tools for making that happen. So even if it means redesigning their workflow or tasking advanced practice nurse with responding to routine queries, it’s worth doing.

Digital Health, Mobile Health, mHealth, etc Is Just Health?

Posted on I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Last week, the big news in the world of healthcare IT was that HIMSS acquired Health 2.0. You can check out the great writeup of the acquisition by Andy Oram. This acquisition was interesting since Health 2.0 had largely tried to be the anti-HIMSS for so long. There were others doing so as well like the mHealth Summitt and the Connected Health Conference, but those have all been acquired by HIMSS as well.

It’s no surprise that running a conference focused on startup companies doing innovative things in healthcare is a hard business. Startup companies have no money and so they can’t spend on oversized booths like the large vendors at HIMSS do. Indu and Matthew did what they could with Health 2.0, but it’s a challenging business. It will be interesting to see how things go under the HIMSS umbrella.

I know that Matthew Holt who started Health 2.0 has been beating the drum for a long time that there’s no such thing as mobile health or mHealth or Digital Health. There’s just healthcare. So, in some ways it makes sense for something like Health 2.0 to be part of a healthcare IT organization like HIMSS.

For the most part, I agree with Matthew on there not being a difference. However, I think that what this misses is that within the healthcare IT world there are companies at different stages of development. I divide these companies into 3 categories: Large Enterprise Companies, Middle Tier Companies, and Startup Companies. We could slice and dice some more, but I think this is a good framework for thinking about the industry.

Whether you liked the description of digital health or mobile health or mHealth, those terms came to represent what most people would consider startup healthcare IT companies. That’s what Health 2.0 and a few other conferences came to represent. Despite many efforts on their part to expand in other ways, HIMSS has largely come to represent the large enterprise companies. They’ve done so in a really fantastic way, but these large enterprise companies kind of suck the wind out of events like the HIMSS Annual conference.

What’s interesting to me is that the middle tier healthcare IT companies haven’t really had a place to go. Sure, they might go to HIMSS, but they generally do smaller booths and they go to show they’re a player in the space versus going to attract customers and do business deals. Same goes for Health 2.0. They might attend Health 2.0 to see what’s happening in the market, but it’s not a great event for their businesses generally either.

Along those same lines, I think that most middle tier hospitals and healthcare organizations get left out as well. They’re too small to be able to be the pilot site for a startup company and they get lost at an event like HIMSS. These middle tier healthcare organizations are interesting because they have money to spend if they can find something that works. However, they don’t have the bandwidth to be someone’s innovation center for something that might work.

No doubt, digital health is just becoming part of the overall healthcare system. However, the division between size of companies and the maturity of their products is not going to change. Not to mention the needs of the various sized healthcare organizations. It will be interesting to see what happens to Health 2.0 under HIMSS and how the market continues to evolve to better serve its stakeholders.