Is Provider Secure Messaging Associated With Patient Messaging Behavior? Evidence From the US Army
Open accessAbstract
BACKGROUND: Secure messaging with health care providers offers the promise of improved patient-provider relationships, potentially facilitating outcome improvements. But, will patients use messaging technology in the manner envisioned by policy-makers if their providers do not actively use it? OBJECTIVE: We hypothesized that the level and type of secure messaging usage by providers might be associated with messaging initiation by their patients. METHODS: The study employed a dataset of health care and secure messaging records of more than 81,000 US Army soldiers and nearly 3000 clinicians with access to a patient portal system. We used a negative binomial regression model on over 25 million observations to determine the adjusted association between provider-initiated and provider-response messaging and subsequent messaging by their patients in this population over a 4-year period. RESULTS: Prior provider-initiated and response messaging levels were associated with new patient messaging when controlling for the patient's health care utilization and diagnoses, with the strongest association for high provider-response messaging level. Patients whose providers were highly responsive to the messages of other patients initiated 334% more secure messages (P<.001) than patients with providers who did not personally respond to other patients' messages. CONCLUSIONS: Our results indicate that provider messaging usage levels and types thereof predict their patients' subsequent communication behavior. The findings suggest the need for more study into the factors associated with provider messaging to fully understand the mechanisms of this relationship.
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“Patients’ expectations are not only dependent on the technology but also on the way in which general practices offer, promote, and use it [22,23].”
From Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care (2018) · cites this paper as [23]
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- Authors
- Wolcott, V., Agarwal, R., & Nelson, D. A.
- Affiliations
- Baylor University (US)
- University of Maryland, College Park (US)
- Stanford Medicine (US)
- Corresponding author
- Wolcott, Vickee
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2017-04-06
- Volume
- 19
- Issue
- 4
- Pages
- e103
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC5399218
- OpenAlex
- W2604684863
- Cited by
- 28
- References
- 16
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 3
- FWCI
- 6.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- secure messaging, patient-provider communication, patient portals, military health services, U.S. Army soldiers, health information technology adoption, patient engagement
- MeSH terms
- Patient Portals, Adult, Communication, Female, Health Personnel, Humans, Male, Middle Aged, Military Personnel, Patient Acceptance of Health Care, Physician-Patient Relations, United States, Electronic Mail
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