EVALUATING SECURE MESSAGING FROM THE VETERAN PERSPECTIVE: INFORMING THE ADOPTION AND SUSTAINED USE OF A PATIENT‐DRIVEN COMMUNICATION PLATFORM

Secure messaging (SM) is a secured asynchronous electronic e-mail system within the Veterans Health Administration web-based patient portal, My Health eVet. This electronic tool is part of a national transformation initiative to create new models of care to support patient-provider communication and promote self-care management. SM is designed to empower patients to communicate with their providers, but to date little research has evaluated Veterans’ perspectives on using SM as a communication tool. This article provides an overview of a qualitative mixed-methods study with 33 Veterans who opted-in to use SM. We used a combination of in-depth interviews, user-testing, three-month review of secondary SM data, and three-month follow-up phone interviews to understand Veterans’ experiences using SM. Synthesizing these data, we identified high- and low-volume users and characterized their reasons for using or not using SM. These profiles illustrate the Veteran perspective, enabling clinicians, administrators, and other stakeholders to understand how to adapt marketing and educational strategies and make system changes to promote and facilitate Veteran adoption and sustained use of SM as a communication tool.

[1]  Rosalie A. Torres Stone,et al.  Adult Willingness to Use Email and Social Media for Peer-to-Peer Cancer Screening Communication: Quantitative Interview Study , 2013, JMIR research protocols.

[2]  M. Crocetti,et al.  Pediatric Caregiver Attitudes Toward Email Communication: Survey in an Urban Primary Care Setting , 2013, Journal of medical Internet research.

[3]  Timothy P. Hogan,et al.  Patient-Provider Secure Messaging in VA: Variations in Adoption and Association With Urgent Care Utilization , 2013, Medical care.

[4]  Sharon E. Straus,et al.  Personal health records: a scoping review , 2011, J. Am. Medical Informatics Assoc..

[5]  Terhilda Garrido,et al.  Improved quality at Kaiser Permanente through e-mail between physicians and patients. , 2010, Health affairs.

[6]  James D. Ralston,et al.  Diabetes Quality of Care and Outpatient Utilization Associated With Electronic Patient-Provider Messaging: A Cross-Sectional Analysis , 2009, Diabetes Care.

[7]  Siamak Noorbaloochi,et al.  Validation of Screening Questions for Limited Health Literacy in a Large VA Outpatient Population , 2008, Journal of General Internal Medicine.

[8]  Daniel Z. Sands,et al.  Can E-Mail Messages Between Patients and Physicians Be Patient-Centered? , 2008, Health communication.

[9]  Terhilda Garrido,et al.  Patient access to an electronic health record with secure messaging: impact on primary care utilization. , 2007, The American journal of managed care.

[10]  Cameron D. Norman,et al.  eHEALS: The eHealth Literacy Scale , 2006, Journal of medical Internet research.

[11]  Laura Johnson,et al.  How Many Interviews Are Enough? , 2006 .

[12]  P. Kummervold,et al.  Patients Who Use E-Mediated Communication With Their Doctor: New Constructions of Trust in the Patient-Doctor Relationship , 2006, Qualitative health research.

[13]  David Young,et al.  Research Paper: Patient Experiences and Attitudes about Access to a Patient Electronic Health Care Record and Linked Web Messaging , 2004, J. Am. Medical Informatics Assoc..

[14]  D. Ford,et al.  Experiences of patients who were early adopters of electronic communication with their physician: satisfaction, benefits, and concerns. , 2004, The American journal of managed care.

[15]  ERIC M. LIEDERMAN,et al.  Research Paper: Web Messaging: A New Tool for Patient-Physician Communication , 2003, J. Am. Medical Informatics Assoc..

[16]  Ulla K. Bunz,et al.  The Computer-Email-Web (CEW) Fluency Scale--Development and Validation , 2001 .

[17]  Kieran Mathieson,et al.  Predicting User Intentions: Comparing the Technology Acceptance Model with the Theory of Planned Behavior , 1991, Inf. Syst. Res..

[18]  R H Jackson,et al.  Rapid assessment of literacy levels of adult primary care patients. , 1991, Family medicine.