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Article
Patient-provider secure messaging in VA: variations in adoption and association with urgent care utilization
Quantitative Health Sciences Publications and Presentations
  • Stephanie L. Shimada, Edith Nourse Rogers Memorial Veterans Hospital,
  • Timothy P. Hogan, University of Massachusetts Medical School
  • Sowmya R. Rao, University of Massachusetts Medical School
  • Jeroan J. Allison, University of Massachusetts Medical School
  • Ann L. Quill, University of Massachusetts Medical School
  • Hua Feng, University of Massachusetts Medical School
  • Barrett Phillips, University of Massachusetts Medical School
  • Kim M. Nazi, U.S. Department of Veterans Affairs
  • Susan T. Haidary, U.S. Department of Veterans Affairs
  • Thomas K. Houston, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
3-1-2013
Document Type
Article
Subjects
Electronic Mail; Professional-Patient Relations; Ambulatory Care; Veterans Health; United States Department of Veterans Affairs
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.
Keywords
  • UMCCTS funding
PubMed ID
23407007
Comments

Citation: Med Care. 2013 Mar;51(3 Suppl 1):S21-8. doi: 10.1097/MLR.0b013e3182780917. Link to article on publisher's site

Related Resources
Link to article in PubMed
Citation Information
Stephanie L. Shimada, Timothy P. Hogan, Sowmya R. Rao, Jeroan J. Allison, et al.. "Patient-provider secure messaging in VA: variations in adoption and association with urgent care utilization" Vol. 51 Iss. 3 Suppl 1 (2013) ISSN: 1537-1948
Available at: http://works.bepress.com/jeroan_allison/167/