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Secure Messaging in a Pediatric Respiratory Medicine Setting

Project Final Report (PDF, 1.14 MB)

Project Details -
Completed

This project evaluated how the implementation of a secure e-mail messaging (e-messaging) system between clinicians and patients and/or guardians affects provider efficiency, utilization of emergency department (ED) for medication refills, and patients' qualitative satisfaction with care in a pediatric respiratory medicine setting. The project was completed at the Yale Pediatric Respiratory Medicine Clinic, a subspecialty clinic in a tertiary care hospital that serves a diverse patient population. Study methods included: 1) pre-implementation survey of patients regarding Internet use, 2) tracking of messages, 3) open-ended qualitative interviews of users and non-users to describe the impact of the system, and 4) description of the implementation process.

Prior to enrollment of patients, a time-motion study was conducted on clinic providers' daily telephone use for scheduling, refills, and answering questions. Study results were compared with post-implementation provider time utilization to determine whether providing care (refills, answering questions, etc.) required similar or different amounts of provider time when conducted electronically.

The investigators found that while every indication was given that this new technology was desired, patients preferred more traditional methods of contact at the clinic. In order for secure messaging systems to be used to improve communication with providers and be part of a patient-centric model of care, they must be integrated into more readily-usable messaging portals and accompanied by content that is of interest to patients and their families.