Consistency of Patient Preferences About a Secure Internet-Based Patient Communications Portal: Contemplating, Enrolling, and Using
Internet-based secure communication portals (portal) have the potential to enhance patient care via improved patient-provider communications. This study examines differences among primary care patients' perceptions when contemplating using, enrolling to use, and using a portal for health care purposes. A total of 3 groups of patients from 1 Midwestern academic medical center were surveyed at different points in time: (1) Waiting Room survey asking about hypothetical interest in using a portal to communicate with their physicians; (2) patient portal Enrollment survey; and (3) Follow-up postenrollment experience survey. Those who enroll and use a patient portal have different demographic characteristics and interest levels in selected portal functions (eg, e-mailing providers, viewing medical records online, making appointments) and initially perceive only limited improvements in care because of the portal. These differences have potential market implications and provide insight into selecting and maintaining portal functions of greater interest to patients who use the portal.
Available from: Jennifer Christner
- "Other studies have shown disparities in email communication with physicians . Higher income, higher education and white race has been associated with higher use of email to communicate with physicians and higher use of internet based patient communications portals    . These differences echo the disparities in internet access termed the digital divide as Americans with lower incomes or lower levels of education are less likely to use a computer or have internet access  . "
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ABSTRACT: OBJECTIVE: Physician-patient email communication is increasing but trainees receive no education on this communication medium. Research eliciting patient preferences about email communication could inform training. Investigators elicited parents' perspectives on physician-parent email communication and compared parent and faculty assessments of medical students' emails. METHODS: This mixed methods study explored physician-parent email communication in 5 parent focus groups using qualitative analyses to identify themes. Differences between faculty and parent assessment scores for students' email responses were calculated using univariate general linear modeling. RESULTS: Themes that emerged were: (1) Building the Relationship, (2) Clarity of Communication and (3) Expectations. Parents criticized student's statements as condescending. The sum of assessment scores by parents and faculty were moderately correlated (r(44)=.407, P<.01), but parents gave students lower scores on "acknowledges validity/expresses empathy" (P=.01) and higher scores on "provides next steps" (P<.01) and "identifies issues" (P<.01). CONCLUSION: Parents place value on students' abilities to communicate clearly and convey respect and empathy in email. Parent and faculty perspectives on email communication are similar but not the same. PRACTICE IMPLICATIONS: Differences between parental and faculty assessments of medical students' emails supports the need for the involvement of patients and families in email communication curriculum development.
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ABSTRACT: To assess veterans' health communication preferences (in-person, telephone, or electronic) for primary care needs and the impact of computer use on preferences.
Structured patient interviews (n=448). Bivariate analyses examined preferences for primary care by 'infrequent' vs. 'regular' computer users.
Only 54% were regular computer users, nearly all of whom had ever used the internet. 'Telephone' was preferred for 6 of 10 reasons (general medical questions, medication questions and refills, preventive care reminders, scheduling, and test results); although telephone was preferred by markedly fewer regular computer users. 'In-person' was preferred for new/ongoing conditions/symptoms, treatment instructions, and next care steps; these preferences were unaffected by computer use frequency. Among regular computer users, 1/3 preferred 'electronic' for preventive reminders (37%), test results (34%), and refills (32%).
For most primary care needs, telephone communication was preferred, although by a greater proportion of infrequent vs. regular computer users. In-person communication was preferred for reasons that may require an exam or visual instructions. About 1/3 of regular computer users prefer electronic communication for routine needs, e.g., preventive reminders, test results, and refills.
These findings can be used to plan patient-centered care that is aligned with veterans' preferred health communication methods.
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