Patient-provider secure messaging in VA: Variations in adoption and association with urgent care utilization

Stephanie L. Shimada, Timothy P. Hogan, Sowmya R. Rao, Jeroan J. Allison, Ann L. Quill, Hua Feng, Barrett D. Phillips, Kim M. Nazi, Susan T. Haidary, Thomas K. Houston

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)S21-S28
JournalMedical Care
Volume51
Issue number3 SUPPL. 1
DOIs
StatePublished - Mar 1 2013
Externally publishedYes

Fingerprint

Ambulatory Care
Veterans
Patient Acceptance of Health Care
Veterans Health
United States Department of Veterans Affairs
Quality of Health Care
Volunteers
Primary Health Care
Cohort Studies
Retrospective Studies
Cross-Sectional Studies
Technology

Keywords

  • ambulatory care
  • continuity
  • implementation
  • Internet
  • secure messaging
  • urgent care
  • veterans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Shimada, S. L., Hogan, T. P., Rao, S. R., Allison, J. J., Quill, A. L., Feng, H., ... Houston, T. K. (2013). Patient-provider secure messaging in VA: Variations in adoption and association with urgent care utilization. Medical Care, 51(3 SUPPL. 1), S21-S28. https://doi.org/10.1097/MLR.0b013e3182780917

Patient-provider secure messaging in VA : Variations in adoption and association with urgent care utilization. / Shimada, Stephanie L.; Hogan, Timothy P.; Rao, Sowmya R.; Allison, Jeroan J.; Quill, Ann L.; Feng, Hua; Phillips, Barrett D.; Nazi, Kim M.; Haidary, Susan T.; Houston, Thomas K.

In: Medical Care, Vol. 51, No. 3 SUPPL. 1, 01.03.2013, p. S21-S28.

Research output: Contribution to journalArticle

Shimada, SL, Hogan, TP, Rao, SR, Allison, JJ, Quill, AL, Feng, H, Phillips, BD, Nazi, KM, Haidary, ST & Houston, TK 2013, 'Patient-provider secure messaging in VA: Variations in adoption and association with urgent care utilization', Medical Care, vol. 51, no. 3 SUPPL. 1, pp. S21-S28. https://doi.org/10.1097/MLR.0b013e3182780917
Shimada, Stephanie L. ; Hogan, Timothy P. ; Rao, Sowmya R. ; Allison, Jeroan J. ; Quill, Ann L. ; Feng, Hua ; Phillips, Barrett D. ; Nazi, Kim M. ; Haidary, Susan T. ; Houston, Thomas K. / Patient-provider secure messaging in VA : Variations in adoption and association with urgent care utilization. In: Medical Care. 2013 ; Vol. 51, No. 3 SUPPL. 1. pp. S21-S28.
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