Houston VA Health Services Research and Development (HSR&D) Center of Excellence, Michael E DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Recent evidence indicates increased access to and use of Internet and non-healthcare-related email by older patients. Because email adoption could potentially reduce some of the disparities faced by this age group, there is a need to understand factors determining older patients' enthusiasm to use email to communicate with their physicians. Electronic mail (email) represents a means of communication that, coupled with face-to-face communication, could enhance quality of care for older patients.
Test a model to determine factors associated with older patients' enthusiasm to use email to communicate with their physicians.
We conducted a secondary data analysis of survey data collected in 2003 for two large, longitudinal, randomized controlled trials. Logistic-regression models were used to model the dichotomous outcome of patient enthusiasm for using email to communicate with their physicians. Explanatory variables included demographic characteristics, health status, use of email with people other than their physician, characteristics of the physician-patient relationship, and physician enthusiasm to use email with patients.
Participants included a pooled sample of 4059 patients over 65 years of age and their respective physicians (n = 181) from community-based practices in Southern California. Although only 52 (1.3%) patient respondents reported that they communicated with their physician by email, about half (49.3%) expressed enthusiasm about the possibility of using it. Odds of being enthusiastic decreased with increased age (by 0.97 for each year over 66) but were significantly higher in African Americans (OR = 2.1, CI = 1.42 - 3.06), Hispanics (OR = 1.6, CI = 1.26 - 2.14) and men (OR = 1.3, CI = 1.1 - 1.5). A perception of better communication skills of their physician, lower quality of interaction with physician in traditional face-to-face encounters, and physician enthusiasm to use email with patients were significantly associated with an enthusiasm to use email. Patients who did not use email at all were less enthusiastic compared to those who used email for other reasons. Half of the physician respondents were not enthusiastic about communicating with patients using email.
Despite perceived barriers such as limited access to the Internet, older patients seem to want to use email to communicate with their physicians.
"Patient Educ Couns (2015), http://dx.doi.org/10.1016/j.pec.2015.02.011 results. Physicians' attitudes and beliefs about direct notification might play an integral role in patients' adoption of these new health communication strategies  . Given an increasing focus on transparency and patient engagement in health care  , it is essential to understand how direct notification will affect health care workflow. "
[Show abstract][Hide abstract] ABSTRACT: To determine physician perspectives about direct notification of normal and abnormal test results.
We conducted a cross-sectional survey at five clinical sites in the US and Australia. The US-based study was conducted via web-based survey of primary care physicians and specialists between July and October 2012. An identical paper-based survey was self-administered between June and September 2012 with specialists in Australia.
Of 1417 physicians invited, 315 (22.2%) completed the survey. Two-thirds (65.3%) believed that patients should be directly notified of normal results, but only 21.3% were comfortable with direct notification of clinically significant abnormal results. Physicians were more likely to endorse direct notification of abnormal results if they believed it would reduce the number of patients lost to follow-up (OR=4.98, 95%CI=2.21-1.21) or if they had personally missed an abnormal test result (OR=2.95, 95%CI=1.44-6.02). Conversely, physicians were less likely to endorse if they believed that direct notification interfered with the practice of medicine (OR=0.39, 95%CI=0.20-0.74).
Physicians we surveyed generally favor direct notification of normal results but appear to have substantial concerns about direct notification of abnormal results.
Widespread use of direct notification should be accompanied by strategies to help patients manage test result abnormalities they receive.
Published by Elsevier Ireland Ltd.
[Show abstract][Hide abstract] ABSTRACT: Processes of communication that guide decision making among clinicians collaboratively caring for complex patients are poorly understood and vary based on local contexts. In this paper, the authors characterize these processes and propose a wiki-style communication model to improve coordination of decision making among clinicians using an integrated electronic health record (EHR).
A narrative review of current patterns of communication among clinicians sharing medical decisions focusing on the emerging and potential roles of EHRs to enhance communication among clinicians caring for complex patients.
. The authors present the taxonomy of decision making and communication among clinicians caring for complex patients. They then adapt wiki-style communication to propose a novel model of communication among clinicians for decision making within multidisciplinary disease management programs. Future innovations using wiki-style communication among clinicians are also described and placed in the context of medical decisions by clinicians working together in disease management programs.
EHR-based wiki-style applications may have the potential to improve communication and care coordination among clinicians caring for complex patients. This could lead to improved quality and safety within multidisciplinary disease management programs.
Medical Decision Making 12/2010; 30(6):722-31. DOI:10.1177/0272989X10385846 · 3.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Die an der Gesundheitsversorgung beteiligten Anspruchsgruppen (z. B. Versicherungen, Ärzte, Krankenhaus- und Patientenverbände, Selbsthilfegruppen) versuchen vermehrt, Gesundheitsinformationen über das Internet zugänglich zu machen und Patienten aktiv in ihre Versorgung mit einzubeziehen. Zudem nutzen viele Patienten das Internet, um sich über ihre Krankheit und mögliche Behandlungsoptionen zu informieren und sich mit anderen Betroffenen auszutauschen. Aus der Perspektive der Wirtschaftsinformatik gibt dieser Beitrag auf Basis einer umfassenden Analyse einen Überblick über den derzeitigen Stand der Grundlagenforschung und der angewandten Forschung im Bereich Gesundheitsinformationen im Internet. Die grundlegenden Kategorien der Analyse bilden die Anspruchsgruppen im Gesundheitswesen, die sie verbindenden Informationsflüsse, die informationentransferierenden technologischen Anwendungen sowie die Kategorien des TEMPEST-Modells. Die Ergebnisse zeigen, dass klassische, transaktionsbezogene E-Health-Anwendungen auch im Kontext internetbasierter Gesundheitsinformationen in einem großen Teil der Beiträge Gegenstand der Untersuchung sind. Bei den Kategorien des TEMPEST-Modells stellt die Technologie-Kategorie den größten Anteil. Basierend auf der Analyse des derzeitigen Standes der Forschung in der Wirtschaftsinformatik werden anschließend Gründe sowie mögliche zukünftige Forschungsfelder diskutiert.
Business and Information Systems Engineering the international journal of Wirtschaftsinformatik 08/2013; 55(4). DOI:10.1007/s11576-013-0369-z · 0.54 Impact Factor
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