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Physicians' Experiences Using Secure Messaging for Diabetes Management: A Qualitative Study.

Ben Kragen1,2, Maryum Zaidi3, Stephanie L Shimada1,4

  • 1Center for Health Optimization and Implementation Research, VA Bedford Healthcare System, 200 Springs Road (152), Building 70, Bedford, MA, 01730, United States, 1 6032052878.

JMIR Diabetes
|September 26, 2025
PubMed
Summary
This summary is machine-generated.

Secure messaging improves type 2 diabetes care efficiency for tasks like refills and scheduling. However, physicians find unstructured patient messages challenging, highlighting a need for better workflow tools.

Keywords:
care coordinationdiabetesdigital healthendocrinologypatient portalsprimary caresecure messaging

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Area of Science:

  • Medical Informatics
  • Diabetes Management
  • Health Communication

Background:

  • The COVID-19 pandemic increased demand for remote type 2 diabetes management via secure messaging.
  • Prior research explored secure messaging content and outcomes for diabetes care.
  • A knowledge gap exists regarding secure messaging's effectiveness for specific clinical tasks and physicians' experiences.

Purpose of the Study:

  • To investigate physicians' experiences using secure messaging for type 2 diabetes management tasks.
  • To understand how secure messaging facilitates or hinders communication for specific clinical activities.

Main Methods:

  • Qualitative study involving semistructured interviews with 10 internists and endocrinologists.
  • Interviews focused on physicians' experiences with secure messaging for 6 diabetes management tasks.
  • Data collected between 2021-2023 and analyzed using the framework method for thematic analysis.

Main Results:

  • Physicians reported secure messaging increased communication frequency and timeliness, improving care coordination.
  • Tasks with clear information needs (e.g., prescription refills, scheduling) were more time-efficient.
  • Physicians experienced frustration with unstructured, often insufficient, patient messages, complicating nonurgent question responses.

Conclusions:

  • Secure messaging supports longitudinal diabetes care, allowing treatment plan iteration between visits.
  • Efficiency gains were noted for tasks with defined information boundaries.
  • A need for workflow technologies to improve message clarity and information sufficiency was identified.