Patient-provider secure messaging in VA: variations in adoption and association with urgent care utilization
Authors
Shimada, Stephanie LHogan, Timothy P.
Rao, Sowmya R.
Allison, Jeroan J.
Quill, Ann L.
Feng, Hua
Phillips, Barrett
Nazi, Kim M.
Haidary, Susan T.
Houston, Thomas K.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2013-03-01Keywords
Electronic MailProfessional-Patient Relations
Ambulatory Care
Veterans Health
United States Department of Veterans Affairs
UMCCTS funding
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: The Veterans Health Administration has implemented patient to clinical team electronic asynchronous secure messaging (SM). This disruptive technology has the potential to support continuous, coordinated quality care, but limited evidence supports this connection. OBJECTIVES: The objective of this paper is to (1) measure SM implementation and identify facility characteristics associated with higher rates of adoption and (2) understand the association of SM use and noncontinuity care [ie, urgent care (UC)] utilization rates. MEASURES: We conducted a retrospective cohort study of 132 VA facilities implementing SM in primary care. We used a combination of cross-sectional survey data on predictors of SM implementation and longitudinal data (July 2010-June 2012) on use of SM and UC. RESULTS: Human resources (coordinator and staff/volunteer availability to directly assist Veterans), computer resources (computers and computer rooms for Veterans), and leadership support for coordinators were associated with increased SM adoption rates. Higher SM use was associated with lower UC rates; early adopters of SM achieved a greater decrease in UC utilization over time than later adopters. CONCLUSIONS: In this exploratory analysis of early SM implementation in VA, we found a path of associations linking SM and reductions in UC utilization. These results suggest a need for further examination of the relationship between SM and its effects on health care utilization patterns.Source
Med Care. 2013 Mar;51(3 Suppl 1):S21-8. doi: 10.1097/MLR.0b013e3182780917. Link to article on publisher's siteDOI
10.1097/MLR.0b013e3182780917Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46604PubMed ID
23407007Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/MLR.0b013e3182780917