Secure Messaging Use Among Patients with Depression: An Analysis Using Real-World Data.

Area of Science:

• Digital Health
• Mental Health Services
• Health Informatics

Background:

• Depression is a prevalent mental health disorder with significant treatment gaps due to limited access and resources.
• Secure messaging (SM) presents a digital solution for patients to communicate non-urgent medical queries, bridging gaps in care.
• This study investigates SM initiation and exchanges as key engagement patterns in self-care health management.

Purpose of the Study:

• To determine if patients with depression engage more with secure messaging (SM) compared to patients without depression.
• To analyze the factors influencing SM initiation and ongoing SM exchanges.
• To evaluate the role of SM telehealth in supporting patients with mental health needs.

Main Methods:

• Analysis of patient portal data from a major academic medical center (January 2018 - December 2022).
• Utilized linear mixed-effects modeling to analyze secure messaging (SM) initiations and exchanges.
• Examined patient engagement across 2,629 zip codes over a five-year period.

Main Results:

• Predictors accounted for 25.1% of the variance in SM initiations and 24.9% in SM exchanges.
• Predictors showed stronger associations with SM exchanges than with SM initiations.
• Findings indicate multifaceted predictors influencing SM utilization, with some enhancing and others impeding use.

Conclusions:

• Secure messaging (SM) telehealth services significantly supported patients with mental health needs more than those without.
• Telehealth, through SM, improves access, communication, and resource allocation for patients.
• SM encourages both the initiation of use and sustained engagement through ongoing exchanges, benefiting mental health care.