Associations Between Patient-Provider Secure Message Content and Patients' Health Care Visits.

Area of Science:

• Health Informatics
• Patient Communication
• Healthcare Management

Background:

• Between-visit communications are crucial for patient outcomes like access to care.
• Secure messaging is increasingly used, but its content's impact on outcomes is understudied.
• Understanding message content's influence on healthcare utilization is essential.

Purpose of the Study:

• To examine the association between secure message content and patient healthcare visits.
• To determine how different types of secure message content correlate with outpatient, emergency department, and inpatient visits.

Main Methods:

• Analysis of 18,309 patient- and staff-generated secure messages from 2,111 adult patients with hypertension and/or diabetes.
• Categorization of message content using taxonomic codes.
• Estimation of incident rate ratios (IRRs) to assess associations between message content and visit frequency.

Main Results:

• Patients initiating secure messages had more outpatient visits.
• Preventive care scheduling requests and new condition appointment requests were inversely associated with outpatient visits.
• Higher proportions of request denials and follow-up appointment requests correlated with increased emergency department visits.
• Threads lacking clinic response showed a positive association with outpatient visits.

Conclusions:

• The content of secure messages significantly influences patient healthcare utilization.
• Specific message types, such as scheduling requests, can reduce outpatient visits.
• Unresolved issues and lack of clinic response in secure messages may lead to increased emergency department use.
• Findings inform optimizing secure messaging strategies to support patient care and manage healthcare resources effectively.