ArticleJournal of medical Internet research2020
Associations Between Patient Health Outcomes and Secure Message Content Exchanged Between Patients and Clinicians: Retrospective Cohort Study.
Article in Journal of medical Internet research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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Who cites it
7 citing papers in PubMed.
- A scoping review of studies on secure messaging through patient portals: persistent challenges and potential solutions.npj health systems · 2026Article
- A Retrospective Analysis of Patient Feedback in a Major Regional General Hospital: Trends and Insights into Healthcare Experience.Journal of patient experience · 2025Article
- The Impact of Secure Messaging in the Treatment of Patients With Diabetes Within a Primary Care Setting: Protocol for a Scoping Review.JMIR research protocols · 2023Article
- Secure Messaging for Diabetes Management: Content Analysis.JMIR diabetes · 2023Article
- Feasibility of a Digital Patient-Provider Communication Intervention to Support Shared Decision-Making in Chronic Health Care, InvolveMe: Pilot Study.JMIR formative research · 2022Article
- Patient and Clinician Characteristics Associated With Secure Message Content: Retrospective Cohort Study.Journal of medical Internet research · 2021Article
- Classification of patient- and clinician-generated secure messages using a theory-based taxonomy.Health science reports · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe number of electronic messages securely exchanged between clinic staff and patients has risen dramatically over the last decade. A variety of studies explored whether the volume of messages sent by patients was associated with outcomes. None of these studies, however, examined whether message content itself was associated with outcomes. Because secure messaging is a significant form of communication between patients and clinic staff, it is critical to evaluate the context of the communication to best understand its impact on patient health outcomes.
objectiveTo examine associations between patients' and clinicians' message content and changes in patients' health outcomes.
methodsWe applied a taxonomy developed specifically for secure messages to 14,394 patient- and clinic staff-generated messages derived from patient-initiated message threads. Our study population included 1602 patients, 50.94% (n=816) of whom initiated message threads. We conducted linear regression analyses to determine whether message codes were associated with changes in glycemic (A1C) levels in patients with diabetes and changes in systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension.
resultsPatients who initiated threads had larger declines in A1Cs (P=.01) compared to patients who did not initiate threads. Clinic nonresponse was associated with decreased SBP (β=-.30; 95% CI -0.56 to -0.04), as were staffs' action responses (β=-30; 95% CI -0.58 to -0.02). Increased DBP, SBP, and A1C levels were associated with patient-generated appreciation and praise messages and staff encouragement with effect sizes ranging from 0.51 (A1C) to 5.80 (SBP). We found improvements in SBP associated with patients' complaints (β=-4.03; 95% CI -7.94 to -0.12). Deferred information sharing by clinic staff was associated with increased SBP (β=1.29; 95% CI 0.4 to 2.19).
conclusionsThis is the first research to find associations between message content and patients' health outcomes. Our findings indicate mixed associations between patient message content and patient outcomes. Further research is needed to understand the implications of this work; in the meantime, health care providers should be aware that their message content may influence patient health outcomes.
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