Patient-Provider Secure Messaging in VA

Variations in Adoption and Association With Urgent Care Utilization

Bibliographic Data

ID9101968
AuthorsStephanie L Shimada (0000-0002-6517-5122, Edith Nourse Rogers Memorial Veterans Hospital), Timothy P Hogan (0000-0002-3086-2483, University of Massachusetts Chan Medical School), Sowmya R Rao (0000-0003-3869-8320, University of Massachusetts Chan Medical School), Jeroan J Allison (0000-0003-4472-2112, University of Massachusetts Chan Medical School), Ann L Quill, Hua Feng (0000-0003-4748-6231, University of Massachusetts Chan Medical School), Barrett D Phillips (0000-0003-4662-6386, University of Massachusetts Chan Medical School), Kim M Nazi (0000-0002-0966-5602), Susan T Haidary, Thomas K Houston (0000-0002-2909-4018, University of Massachusetts Chan Medical School)
Year2013
Volume51
Issue3 Suppl 1
PagesS21-S28
Publication date2013-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3182780917
PMID23407007
OpenAlexW2001938368
LanguageEN
Citations received5
References cited13

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

Cohort · Family medicine · Health care · Health information technology · Medical emergency · Veterans Affairs · Electronic Health Records Systems · Healthcare Policy and Management · Medicine · Nursing · Telemedicine and Telehealth Implementation