How secure messaging helps this doctor connect with patients

I commented on a blog post recently that cited a recent study called “Secure web messaging between patients and doctors: Not well received.” I was pleased to see that other professionals who left comments had the same reaction I did to the study: it is  simply not accurate. I have 4,900 patients and five other physicians in our practice who can attest that secure messaging, when used the right way, is an invaluable tool that has improved efficiency, and empowered our patients with access to their doctors and their health information.

The study was published by Pediatrics, the official journal of the American Academy of Pediatrics. The authors of the article studied how patients in an outpatient, academic pediatric respiratory clinic in New Haven were using the clinic’s Secure Messaging to communicate with providers. They found that in 8 months, only 5 messages were initiated by patients. Makes it sound like patients do not find value in secure messaging, right? That is a broad statement when looking at only 127 patients at an academic clinic, and I strongly believe it is not representative at all of the overall health industry’s experience.

No practice or health system of any size can expect patients to adopt a technology like secure messaging if they do not  have a platform from which patients can easily access and use it. Through our Kryptiq Patient Portal, powered by their secure messaging, our patients schedule appointments, email their physicians with questions (and receive responses), refill prescriptions and access their lab results.

I gather from the article that the clinic was not using a patient portal to host the secure messaging solution. I also think it is safe to assume they were not educating their patients – or their parents — about all the benefits of using secure messaging to communicate with their practice.

The other key factor in getting patients to use secure messaging: tell them it’s there! We are always talking to new and existing patients about how easy the patient portal makes their care experience out of our offices. We use technology to expand the doctor patient relationship beyond the office. When most patients use it, they are  hooked. We average over fifty new users per week. The result is fewer phone calls to our office staff about issues that can be easily answered through secure messaging. That frees our staff to field calls from new patients and streamline urgent calls. It’s a win-win.

Kryptic provides the platform, but the success is dependent physicians and staff. Train medical assistants to use it. This means breaking their habit of using the telephone. Show them how it will save time and improve documentation. Train the front office to send messages to patients. If a practice is not successful using it, then he or she is not engaging the people around them. Empower your patients by giving them access to their charts.

My advice to any practice or organization considering secure messaging is to do it right. Work with a company like Kryptiq, that offers software that is integrated with your existing EHR and workflow; use the software they offer to make secure messaging work for your patients, including a patient portal to create an easy-to-use base for communication; and let your patients know how much they’ll get out of using it. Trust me, you won’t know how you ever functioned without it and your patients will appreciate it.

Jeff Livingston is an obstetrician-gynecologist at MacArthur OB/GYN, also on Facebook.  He can be reached on Twitter @macobgyn.

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  • http://briarcroft.wordpress.com Emily Gibson M.D.

    This is our experience as well–we inform patients that the secure web portal (Webview) connected with our EMR (Practice Partner) is our primary communication tool.   Labs, xray reports, follow up messages, patient education materials and copies of their clinic notes are all available on line within hours of their clinic visit.  We track whether or not the patient has accessed their web portal and messages and if they have not within a week, we will call them to remind them they have a message waiting for them.

    It has saved much time in phone calling, redundant documentation and provides the patient with direct access to their provider.  We’ll never look back.

    Emily Gibson M.D.

  • http://www.facebook.com/people/Ardella-Eagle/840440226 Ardella Eagle

    Great idea and implementation.  Glad to hear that it’s working for you and your patients.  I just wish it wasn’t free advertising for Kryptic or Webview.

  • Name1

    It’s all personal opinion – the post and the positive comment. The study conclusion contradicts that. It would be helpful if the blog author provides some reference links. 

  • http://briarcroft.wordpress.com/ Emily Gibson

    There is more data out there that is more compelling than a small study of apparent dissatisfaction or lack of use of web portals in a pediatrics practice.  Consider Kaiser Permanente
    http://xnet.kp.org/newscenter/pressreleases/nat/2010/070710ehrupsquality.html
    and Group Health Cooperative
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1480004/

    I have not yet calculated the precise numbers in our student health center practice to determine patient initiated vs. provider initiated messaging but I do know that at least 50% of the copies of progress notes sent to patients are viewed by the patient within 24 hours.  Our goal is to increase that to at least 75% in the next year.

    Emily

  • Kristine C

    Patient Portal messaging is a wonderful communication tool for patients and physicians. A few questions: Would you include patient portal messages in the patient’s medical record? For example, what if a patient reports symptoms or seeks medical advice over a portal message?

    • Emily Gibson

      Patient portal messages automatically come to the electronic chart and can be recorded in the progress notes in addition to a “messages” section of the chart.  It is a part of the record, which is what makes it so much more efficient than describing a phone call in a note after the fact.

      • Kristine C

        If a patient sends a message to his physician describing his symptoms – for example, a 106 degree fever and dizziness – do you have concerns with authenticating his symptoms and automatically including those in the medical record? What if those self-measurements are inaccurate?

        • Emily Gibson

          This is no different than the same kind of symptoms reported over the phone–you need to sort through the information provided by the patient but in this case the patient’s self report and your reply are recorded as is, instead of summarized by the provider.

          Patients may report all kinds of things that turn out to be irrelevant or inaccurate but they are part of the puzzle the provider must deal with.

          • Kristine C

            Thank you for your responses!

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