Prevalence and Risk Profile Of Unread Messages To Patients In A Patient Web Portal

Area of Science:

• Health Informatics
• Patient Communication
• Digital Health

Background:

• Physician-patient electronic communication adoption faces challenges due to potential clinical and legal risks.
• Untimely patient message review can lead to duplicated efforts and compromise patient safety.

Purpose of the Study:

• To evaluate the prevalence and risk factors associated with unread messages within a patient portal.
• To assess the impact of unread messages on patient care and safety.

Main Methods:

• Analysis of six years (2005-2010) of physician-to-patient clinical messages from a patient portal.
• Exclusion of announcement messages and physician-initiated outreach messages (sent to >5 patients) from general analysis.
• Chart review of 75 unread clinical messages to identify any evidence of patient harm or care delays.

Main Results:

• 3% of clinical messages remained unread after 21 days; outreach messages had a 50% unread rate.
• Messages sent outside business hours, and patients who were male, African American, Hispanic, or in the lowest income group, were more likely to have unread messages.
• No direct harm was found, but 13% of unread messages indicated potential care delays.

Conclusions:

• Secure messaging is generally safe, but improved systems for tracking unread messages are warranted.
• Physician outreach messages have a high unread rate, cautioning against their use for critical information dissemination.
• Observed disparities in message readability by race and income necessitate further investigation.