Journal of General Internal Medicine

, Volume 24, Issue 3, pp 349–355 | Cite as

Patient Use of Secure Electronic Messaging Within a Shared Medical Record: A Cross-sectional Study

  • James D. Ralston
  • Carolyn M. Rutter
  • David Carrell
  • Julia Hecht
  • David Rubanowice
  • Gregory E. Simon
Original Article

ABSTRACT

BACKGROUND

Most patients would like to be able to exchange electronic messages with personal physicians. Few patients and providers are exchanging electronic communications.

OBJECTIVE

To evaluate patient characteristics associated with the use of secure electronic messaging between patients and health care providers.

DESIGN, SETTING, AND PATIENTS

Cross-sectional cohort study of enrollees over 18 years of age who were enrolled in an integrated delivery system in 2005.

MEASUREMENTS AND MAIN RESULTS

Among eligible enrollees, 14% (25,075) exchanged one or more secure messages with a primary or specialty care provider between January 1, 2004 and March 31, 2005. Higher secure messaging use by enrollees was associated with female gender (OR, 1.15; 95% CI, 1.10–1.19), greater overall morbidity (OR, 5.64; 95% CI, 5.07–6.28, comparing high or very high to very low overall morbidity), and the primary care provider’s use of secure messaging with other patients (OR, 1.94; 95% CI, 1.67–2.26, comparing 20–50% vs. ≤10% encounters through secure messaging). Less secure messaging use was associated with enrollee age over 65 years (OR, 0.65; CI, 0.59–0.71) and Medicaid insurance vs. commercial insurance (OR, 0.81; 95% CI, 0.68–0.96).

CONCLUSIONS

In this integrated group practice, use of patient–provider secure messaging varied according to individual patient clinical and sociodemographic characteristics. Future studies should clarify variation in the use of electronic patient–provider messaging and its impact on the quality and cost of care received.

KEY WORDS

physician–patient relations electronic mail healthcare disparities 

Notes

Acknowledgements

This study was funded by the Agency for Health Care Research and Quality (Grant No. R03 HS014625–01). The authors thank Gwendolyn Schweitzer for her help in preparing this manuscript.

Funding Sources

This study was funded by the Agency for Health Care Research and Quality (Grant No. R03HS014625–01).

Human Subjects Protections Review and Approval

This study was reviewed and approved by the Group Health Center for Health Studies InstitutionalReview Board.

Conflict of Interest Statement

James D Ralston received grant funding from Sanofi-Aventis between 7/1/2004 and 6/30/2006.

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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • James D. Ralston
    • 1
  • Carolyn M. Rutter
    • 1
  • David Carrell
    • 1
  • Julia Hecht
    • 1
  • David Rubanowice
    • 1
  • Gregory E. Simon
    • 1
  1. 1.Group Health CooperativeCenter for Health StudiesSeattleUSA

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