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Examining the Complexity of Patient-Outpatient Care Team Secure Message Communication: Qualitative Analysis
Holly Jordan Lanham1,2,3, Luci K Leykum1,2,3, Jacqueline A Pugh1,3
1Division of General and Hospital Medicine, Department of Medicine, University of Texas Health San Antonio, San Antonio, TX, United States.
Journal of Medical Internet Research
|July 13, 2018
Summary
Patients increasingly use secure messaging for both routine and nonroutine health issues, revealing potential patient safety concerns. New information systems are needed to manage this complex communication tool effectively.
Area of Science:
- Health Informatics
- Patient-Provider Communication
- Information Systems
Background:
- Secure messaging is valuable for routine patient care.
- Patient use of secure messaging for routine and nonroutine issues, and its implications, are not fully understood.
Purpose of the Study:
- Examine secure messaging use in outpatient settings.
- Generate research questions to improve understanding of secure messaging's role in patient-provider communication.
Main Methods:
- Qualitative analysis of 70 secure message threads from 12 US Department of Veterans Affairs clinics.
- Analyzed 179 communications for patterns and content.
- Utilized information systems and complexity science theories.
Main Results:
- Identified themes: information management, uncertainty management, and patient safety/engagement.
- Secure messages primarily used for routine information exchange and problem-solving.
- Nonroutine uses (relationship building, sensemaking, urgent issues, unresolved issues) require attention.
Conclusions:
- Patients use secure messaging for both routine and nonroutine purposes.
- Potential patient safety concerns arise with complex issues communicated via secure messaging.
- New information system designs are needed to accommodate secure messaging's nuanced use for complex health topics.
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