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Rapid growth in surgeons’ use of secure messaging in a patient portal

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Abstract

Background

Use of secure messaging through patient portals has risen substantially in recent years due to provider incentives and consumer demand. Secure messaging may increase patient satisfaction and improve outcomes, but also adds to physician workload. Most prior studies of secure messaging focused on primary care and medical specialties. We examined surgeons’ use of secure messaging and the contribution of messaging to outpatient interactions in a broadly deployed patient portal.

Methods

We determined the number of clinic visits and secure messages for surgical providers in the first 3 years (2008–2010) after patient portal deployment at an academic medical center. We calculated the proportion of outpatient interaction conducted through messaging for each specialty. Logistic regression models compared the likelihood of message-based versus clinic outpatient interaction across surgical specialties.

Results

Over the study period, surgical providers delivered care in 648,200 clinic visits and received 83,912 messages, with more than 200 % growth in monthly message volume. Surgical specialties receiving the most messages were orthopedics/podiatry (25.1 %), otolaryngology (20.1 %), urology (10.8 %), and general surgery (9.6 %); vascular surgery (0.8 %) and pediatric general surgery (0.2 %) received the fewest. The proportion of outpatient interactions conducted through secure messaging increased significantly from 5.4 % in 2008 to 15.3 % in 2010 (p < 0.001) with all specialties experiencing growth. Heart/lung transplantation (74.9 %), liver/kidney/pancreas transplantation (69.5 %), and general surgery (48.7 %) had the highest proportion of message-based outpatient interaction by the end of the study.

Conclusions

This study demonstrates rapid adoption of online secure messaging across surgical specialties with significant growth in its use for outpatient interaction. Some specialties, particularly those with long-term follow-up, interacted with patients more through secure messaging than in person. As surgeons devote more time to secure messaging, additional research will be needed to understand the care delivered through online interactions and to develop models for reimbursement.

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Acknowledgments

Robert Cronin and Sharon Davis were supported by the 5T15LM007450-12 training grant from the National Library of Medicine.

Disclosures

Dr. Jackson receives salary support from funding given to Vanderbilt University Medical Center by West Health for a research project involving automated telephone call technologies. Mr. Shenson, Dr. Cronin, Ms. Davis, and Dr. Chen have no conflict of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. School of Medicine, Vanderbilt University, Nashville, TN, USA

    Jared A. Shenson

  2. Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA

    Robert M. Cronin, Sharon E. Davis, Qingxia Chen & Gretchen Purcell Jackson

  3. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Robert M. Cronin

  4. Department of Biostatistics, Vanderbilt University, Nashville, TN, USA

    Qingxia Chen

  5. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA

    Gretchen Purcell Jackson

  6. Department of Pediatric Surgery, Vanderbilt University Medical Center, 2200 Children’s Way, Suite 7100, Nashville, TN, 37232, USA

    Gretchen Purcell Jackson

Authors
  1. Jared A. Shenson
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  4. Qingxia Chen
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  5. Gretchen Purcell Jackson
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Corresponding author

Correspondence to Jared A. Shenson.

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Shenson, J.A., Cronin, R.M., Davis, S.E. et al. Rapid growth in surgeons’ use of secure messaging in a patient portal. Surg Endosc 30, 1432–1440 (2016). https://doi.org/10.1007/s00464-015-4347-y

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  • DOI: https://doi.org/10.1007/s00464-015-4347-y

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