patient-generated secure messages and evisits on a patient portal

Many major medical institutions now have patient portals, which allow patients electronic access to appointment scheduling, medication refills, and secure communication with their provider or care team.1–3In the USA, major health systems offering patient portals include the Veterans Health Administration, Partners HealthCare, Intermountain Healthcare, University of Pittsburgh, Kaiser Permanente, Cleveland Clinic, and Mayo Clinic.4–7Some patient portals offer not only the ability to send secure messages to their provider but also offer structured communication about symptoms, termed eVisits.8–10The structured communication in eVisits is intended to provide sufficient symptom information for the provider to make an assessment about the need for further care.

Full Answer

How secure is your patient portal messaging?

Mar 21, 2022 · Both secure messages and eVisits were handled first by a nurse before being resolved or forwarded to a provider, appointment secretary, or other recipient based on the content of the message. Secure messages and eVisits were captured in their entirety and identified by patient clinic numbers and the time the messages were sent.

What drives patient willingness to initiate secure messaging?

Background: Patient portals are becoming increasingly common, but the safety of patient messages and eVisits has not been well studied. Unlike patient-to-nurse telephonic communication, patient messages and eVisits involve an asynchronous process that could be hazardous if patients were using it for time-sensitive symptoms such as chest pain or dyspnea.

Can secure message engagement improve patient engagement?

This study examined only primary care patient- we cleaned the dataset of those messages ( pediatric and many generated messages from the portal during the time frame of adult surrogate messages). 7 April 2010 to 20 August 2011, when primary care patients We used data from the National Hospital Ambulatory had sole access to portal messaging.

Why do patients initiate messages to healthcare providers?

Patient portal messages contain diverse content, ranging from important medical questions to social exchanges [5,9, [12] [13][14][15]. A taxonomy of …

What is patient portal Secure messaging?

What information is excluded from a patient portal?

How do you secure a patient portal?

What are the features of a patient portal?

What information can be accessed through a patient portal?

What is the protected health information?

What are the security issues associated with engaging patients through an online patient portal?

What must be done when creating a patient portal?

What are the benefits of patient portals?

What is portal message?

What are the five main features of the new healthcare portal?

What are the different types of patient portals?

What is a patient portal?

Background: Patient portals are online applications that allow patients to interact with healthcare organizations and view information. Portal messages exchanged between patients and providers contain diverse types of communications, including delivery of medical care. The types of communications and complexity of medical decision-making in portal messages sent to surgeons have not been studied. Materials and methods: We obtained all message threads initiated by patients and exchanged with surgical providers through the Vanderbilt University Medical Center patient portal from June 1 to December 31, 2014. Five hundred randomly selected messages were manually analyzed by two research team members to determine the types of communication (i.e., informational, medical, logistical, or social), whether medical care was delivered, and complexity of medical decision-making as defined for outpatient billing in each message thread. Results: A total of 9408 message threads were sent to 401 surgical providers during the study period. In the 500 threads selected for detailed analysis, 1293 distinct issues were communicated, with an average of 2.6 issues per thread. Medical needs were communicated in 453 message threads (90.6%). Further, 339 message threads (67.8%) contained medical decision-making. Overall complexity of medical decision-making was straightforward in 210 messages (62%), low in 102 messages (30%), and moderate in 27 messages (8%). No highly complex decisions were made over portal messaging. Conclusions: Through patient portal messages, surgeons deliver substantial medical care with varied levels of medical complexity. Models for compensation of online care must be developed as consumer and surgeon adoption of these technologies increases.

What are the challenges of online access?

The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

What is UGC in health?

Objective: User-generated content (UGC) in online environments provides opportunities to learn an individual's health status outside of clinical settings. However, the nature of UGC brings challenges in both data collecting and processing. The purpose of this study is to systematically review the effectiveness of applying machine learning (ML) methodologies to UGC for personal health investigations. Materials and methods: We searched PubMed, Web of Science, IEEE Library, ACM library, AAAI library, and the ACL anthology. We focused on research articles that were published in English and in peer-reviewed journals or conference proceedings between 2010 and 2018. Publications that applied ML to UGC with a focus on personal health were identified for further systematic review. Results: We identified 103 eligible studies which we summarized with respect to 5 research categories, 3 data collection strategies, 3 gold standard dataset creation methods, and 4 types of features applied in ML models. Popular off-the-shelf ML models were logistic regression (n = 22), support vector machines (n = 18), naive Bayes (n = 17), ensemble learning (n = 12), and deep learning (n = 11). The most investigated problems were mental health (n = 39) and cancer (n = 15). Common health-related aspects extracted from UGC were treatment experience, sentiments and emotions, coping strategies, and social support. Conclusions: The systematic review indicated that ML can be effectively applied to UGC in facilitating the description and inference of personal health. Future research needs to focus on mitigating bias introduced when building study cohorts, creating features from free text, improving clinical creditability of UGC, and model interpretability.

Is telemedicine a primary care?

Introduction: This article presents the scientific evidence for the merits of telemedicine interventions in primary care. Although there is no uniform and consistent definition of primary care, most agree that it occupies a central role in the healthcare system as first contact for patients seeking care, as well as gatekeeper and coordinator of care. It enables and supports patient-centered care, the medical home, managed care, accountable care, and population health. Increasing concerns about sustainability and the anticipated shortages of primary care physicians have sparked interest in exploring the potential of telemedicine in addressing many of the challenges facing primary care in the United States and the world. Materials and methods: The findings are based on a systematic review of scientific studies published from 2005 through 2015. The initial search yielded 2,308 articles, with 86 meeting the inclusion criteria. Evidence is organized and evaluated according to feasibility/acceptance, intermediate outcomes, health outcomes, and cost. Results: The majority of studies support the feasibility/acceptance of telemedicine for use in primary care, although it varies significantly by demographic variables, such as gender, age, and socioeconomic status, and telemedicine has often been found more acceptable by patients than healthcare providers. Outcomes data are limited but overall suggest that telemedicine interventions are generally at least as effective as traditional care. Cost analyses vary, but telemedicine in primary care is increasingly demonstrated to be cost-effective. Conclusions: Telemedicine has significant potential to address many of the challenges facing primary care in today's healthcare environment. Challenges still remain in validating its impact on clinical outcomes with scientific rigor, as well as in standardizing methods to assess cost, but patient and provider acceptance is increasingly making telemedicine a viable and integral component of primary care around the world.

Is healthcare more complex than ever before?

Modern healthcare is more complex than ever before, with a broader range of care providers, organizations, diagnostic approaches and treatments. The result is that accurate and timely information is more important than ever. In response, clinical use of health information technology has grown significantly in recent years and there is growing interest in the use of consumer health solutions. In this article, the authors discuss the current landscape of the latter in Canada, enablers and barriers to their adoption and our readiness for change.

Why is secure messaging important?

Secure messages help build better patient-provider relationships through more frequent and convenient communication. “Better patient-provider communication is important because their relationship is at the center of health care service delivery,” said a research team from Army-Baylor University.

What is Stage 2 Meaningful Use?

Under Stage 2 Meaningful Use, providers only needed to exchange secure messages with one unique patient. However, lowering the standard for secure message exchange and patient engagement is likely not the answer, the researchers suggested. Instead, providers must engage their patients using secure messaging.

Introduction

Methods

Results

• Patient demographics and message content
  There was a total of 8789 secure messages and eVisits from 3024 patients during the study interval. Of those, we excluded 492 messages (5.6%) that were generated by 154 (5.1%) patients who declined research participation. We also excluded all 494 messages from the pediatric prac…
• Provider recipients of messages
  There were 241 provider recipients of messages (101 trainees and 140 staff). Staff providers received 6772 messages (93%), while the postgraduate trainees received 550 (7%). Staff providers received a median of 34 messages each; trainees received a median of four messages.

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Discussion

Acknowledgments

Contributors

References