Descriptive examination of secure messaging in a longitudinal cohort of diabetes patients in the ECLIPPSE study

Anupama Gunshekar Cemballi; Andrew J Karter; Dean Schillinger; Jennifer Y Liu; Danielle S McNamara; William Brown; Scott Crossley; Wagahta Semere; Mary Reed; Jill Allen; Courtney Rees Lyles

doi:10.1093/jamia/ocaa281

Descriptive examination of secure messaging in a longitudinal cohort of diabetes patients in the ECLIPPSE study

J Am Med Inform Assoc. 2021 Jun 12;28(6):1252-1258. doi: 10.1093/jamia/ocaa281.

Authors

Anupama Gunshekar Cemballi^{1

2}, Andrew J Karter^{1

3}, Dean Schillinger^{1

2

3}, Jennifer Y Liu³, Danielle S McNamara⁴, William Brown^{2

5

6}, Scott Crossley⁷, Wagahta Semere^{1

2}, Mary Reed³, Jill Allen⁸, Courtney Rees Lyles^{1

2

3

6}

Affiliations

¹ Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, California, USA.
² Center for Vulnerable Populations, University of California, San Francisco, San Francisco, California, USA.
³ Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
⁴ Department of Psychology, Arizona State University, Tempe, Arizona, USA.
⁵ Division of Prevention Science, Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA.
⁶ Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, California, USA.
⁷ Department of Applied Linguistics and ESL, Georgia State University, Atlanta, Georgia, USA.
⁸ Kaiser Research Insights and Operations, Kaiser Permanente, Pleasanton, California, USA.

Abstract

The substantial expansion of secure messaging (SM) via the patient portal in the last decade suggests that it is becoming a standard of care, but few have examined SM use longitudinally. We examined SM patterns among a diverse cohort of patients with diabetes (N = 19 921) and the providers they exchanged messages with within a large, integrated health system over 10 years (2006-2015), linking patient demographics to SM use. We found a 10-fold increase in messaging volume. There were dramatic increases overall and for patient subgroups, with a majority of patients (including patients with lower income or with self-reported limited health literacy) messaging by 2015. Although more physicians than nurses and other providers messaged throughout the study, the distribution of health professions using SM changed over time. Given this rapid increase in SM, deeper understanding of optimizing the value of patient and provider engagement, while managing workflow and training challenges, is crucial.

Keywords: diabetes; electronic health record; longitudinal studies; patient portals; secure messaging.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Cohort Studies
Diabetes Mellitus*
Electronic Mail
Health Literacy*
Humans
Patient Portals*

Abstract

Publication types

MeSH terms

Grants and funding