Patient-initiated e-mails to providers

associations with out-of-pocket visit costs, and impact on care-seeking and health

Mary Reed, Ilana Yonas, Nancy Gordon, Vicki Fung

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVES: To understand when patients use secure e-mail messaging with healthcare providers across several types of questions or concerns, associations between out-of-pocket costs for in-person visits and use of secure messaging, and to examine patient-reported impacts on care-seeking behavior and overall health.

STUDY DESIGN: Cross-sectional survey of patients in an integrated healthcare delivery system, with access to a patient portal to send secure e-mail messages to providers at no out-of-pocket cost.

METHODS: The study included patients with a chronic condition (N = 1041). We described patient-reported preferences for contacting providers and patient-reported impact of e-mail use on phone calls, in-person visits, and overall health. We used multivariate analyses to examine patient characteristics associated with using e-mail as a first contact method, and effects on care-seeking and health.

RESULTS: Overall, 56% of patients sent their provider an e-mail within 1 year, and 46% reported e-mail as their first method of contact for 1 or more types of medical concerns. After adjustment, higher out-of-pocket costs for in-person visits were significantly associated with choosing e-mail as a first method of contact (P < .05). Among patients who had e-mailed their provider, 42% reported that it reduced their phone contacts, 36% reduced in-person office visits and 32% reported e-mailing improved their overall health.

CONCLUSIONS: Patients reported using e-mail broadly to initiate conversations with their providers, and patients with higher out-of-pocket costs for in-person visits were more likely to choose e-mail as a first contact method. Use of secure e-mails reduced patients' use of other types of healthcare and resulted in improved overall health.

Original languageEnglish (US)
Pages (from-to)e632-e639
JournalThe American journal of managed care
Volume21
Issue number12
StatePublished - Dec 1 2015
Externally publishedYes

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Postal Service
Health Expenditures
Delivery of Health Care
Health
Patient Acceptance of Health Care
Integrated Delivery of Health Care
Office Visits
Patient Preference
Health Personnel
Multivariate Analysis
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Health Policy

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Patient-initiated e-mails to providers : associations with out-of-pocket visit costs, and impact on care-seeking and health. / Reed, Mary; Yonas, Ilana; Gordon, Nancy; Fung, Vicki.

In: The American journal of managed care, Vol. 21, No. 12, 01.12.2015, p. e632-e639.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVES: To understand when patients use secure e-mail messaging with healthcare providers across several types of questions or concerns, associations between out-of-pocket costs for in-person visits and use of secure messaging, and to examine patient-reported impacts on care-seeking behavior and overall health.STUDY DESIGN: Cross-sectional survey of patients in an integrated healthcare delivery system, with access to a patient portal to send secure e-mail messages to providers at no out-of-pocket cost.METHODS: The study included patients with a chronic condition (N = 1041). We described patient-reported preferences for contacting providers and patient-reported impact of e-mail use on phone calls, in-person visits, and overall health. We used multivariate analyses to examine patient characteristics associated with using e-mail as a first contact method, and effects on care-seeking and health.RESULTS: Overall, 56{\%} of patients sent their provider an e-mail within 1 year, and 46{\%} reported e-mail as their first method of contact for 1 or more types of medical concerns. After adjustment, higher out-of-pocket costs for in-person visits were significantly associated with choosing e-mail as a first method of contact (P < .05). Among patients who had e-mailed their provider, 42{\%} reported that it reduced their phone contacts, 36{\%} reduced in-person office visits and 32{\%} reported e-mailing improved their overall health.CONCLUSIONS: Patients reported using e-mail broadly to initiate conversations with their providers, and patients with higher out-of-pocket costs for in-person visits were more likely to choose e-mail as a first contact method. Use of secure e-mails reduced patients' use of other types of healthcare and resulted in improved overall health.",
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