Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

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.

Five Challenges of mHealth

Posted on October 23, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

What are some of the challenges that have been found with mHealth? Fierce Mobile Health Care discussed five of the most pressing ones that were listed in a recent article at the Journal of Medical Internet Research. The reasons are:

  • Privacy
  • Data security
  • Funding
  • A lack of good examples of the efficacy and cost effectiveness of mHealth in practice
  • The need for the more high-quality research

These are definitely concerns for a reason. As I’ve reviewed different mHealth apps and websites, I often find myself wondering about the privacy — is my information somehow being tracked? I especially have thought about this as I’ve started using a patient portal for my son’s health care. I don’t want anyone being able to view private information concerning my son. One would hope that before launching these services, potential data breaches have been prevented as much as possible. However, it is a risk that one takes when allowing their information (or, in my case, my son’s) to be put in a place that may be a victim of a data breach.

I think one of the biggest issues is that of keeping people involved. I mean, it’s easy to get excited about mHealth, but it’s also very easy to fall of that bandwagon. There needs to be away to keep patient engagement high . . . Though I’m not sure what that would be.

I don’t know much about the other issues cited, but as I read the journal entry and the article as well, I could definitely see why there is cause for concern. I just wonder what can be done — any suggestions? What do you feel are the biggest challenges mHealth faces?

Could a Mobile App Actually Detect an Acute Stroke?

Posted on May 12, 2011 I Written By

A very interesting study was recently conducted in Canada that may very well lead to the widespread use of mobile apps in clinical situations.  There are already numerous apps that can help patients deal with managing diseases such as diabetes, asthma, and even cancer treatments, but this study, published by the Journal of Medical Internet Research suggests that mobile apps may also be effective in clinical situations.

The study took place in Calgary, Alberta, Canada and utilized a teleradiology system for the diagnosis of acute stroke.  I am no doctor, and I don’t claim to understand most of what was in the actual report, but there are a few things that I did understand that could prove to be extremely noteworthy in the future.

The study used currently available smart phones to see if the devices could handle the imagery necessary to make an accurate and timely diagnosis of acute stroke.

According to the study, “The sensitivity, specificity, and accuracy of detecting intraparenchymal hemorrhage were 100% using the iOS device…”.  Like I said, I am no doctor, but 100% is pretty darn good when it comes to diagnosing any kind of disease or injury.  While the results are impressive the study ultimately had the following conclusion:

The smartphone client-server teleradiology system appears promising and may have the potential to allow urgent management decisions in acute stroke. However, this study was retrospective, involved relatively few patient studies, and only two readers. Generalizing conclusions about its clinical utility, especially in other diagnostic use cases, should not be made until additional studies are performed.

As they stated in their own report this is an extremely small sample size with plenty of restrictions and shortcomings, but it does shed some light on what the future may hold.  With further studies and research doctors may well be able to save lives using their smartphones.  I am sure there will be plenty of naysayers out there, but if we have the technology to save lives we are only hurting ourselves if we don’t use it.