Cargando…
Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study
OBJECTIVE: To assess associations between secure patient–clinician email use and clinical services utilisation over time. DESIGN: Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences b...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654385/ https://www.ncbi.nlm.nih.gov/pubmed/26553841 http://dx.doi.org/10.1136/bmjopen-2015-009557 |
_version_ | 1782402048642252800 |
---|---|
author | Meng, Di Palen, Ted E Tsai, Joanne McLeod, Melanie Garrido, Terhilda Qian, Heather |
author_facet | Meng, Di Palen, Ted E Tsai, Joanne McLeod, Melanie Garrido, Terhilda Qian, Heather |
author_sort | Meng, Di |
collection | PubMed |
description | OBJECTIVE: To assess associations between secure patient–clinician email use and clinical services utilisation over time. DESIGN: Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences between propensity score-matched groups of secure patient–clinician email users and non-users for utilisation 1–12 months before and 7–18 months after first email (users) or a randomly assigned index date (non-users). SETTING: US integrated healthcare delivery system. PARTICIPANTS: 9345 adults with first secure email use between July 2011 and July 2012 and continuous enrolment for ≥30 months and 9345 adults without secure email use between July 2010 and July 2012 matched to users on demographics, health status, and baseline utilisation. PRIMARY OUTCOME MEASURES: Rates of office visits, patient-initiated phone calls, scheduled telephone visits, after-hours clinic visits, emergency department visits, and hospitalisations. RESULTS: After controlling for multiple factors, no statistically significant differences in utilisation between secure email users and non-users occurred. Utilisation transiently increased by 88–237% around first email use. Annual rates of patient-initiated phone calls decreased among secure email users, 0.2 fewer calls per person (95% CI −0.3 to −0.1), from a mean of 4.1 calls per person 1–12 months before first use to a mean of 3.8 calls per person 7–18 months after first use. Rates of patient-initiated phone calls also decreased among non-users, 0.1 fewer calls per person (95% CI −0.2 to 0.0), from a mean of 4.2 calls per person 1–12 months before the index date to mean of 4.1 calls per person 7–18 months after the index date. CONCLUSIONS: Compared with non-users, patient use of secure email with clinicians was not associated with statistically significant differences in clinical services utilisation 7–18 months after first use. |
format | Online Article Text |
id | pubmed-4654385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-46543852015-12-02 Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study Meng, Di Palen, Ted E Tsai, Joanne McLeod, Melanie Garrido, Terhilda Qian, Heather BMJ Open Health Informatics OBJECTIVE: To assess associations between secure patient–clinician email use and clinical services utilisation over time. DESIGN: Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences between propensity score-matched groups of secure patient–clinician email users and non-users for utilisation 1–12 months before and 7–18 months after first email (users) or a randomly assigned index date (non-users). SETTING: US integrated healthcare delivery system. PARTICIPANTS: 9345 adults with first secure email use between July 2011 and July 2012 and continuous enrolment for ≥30 months and 9345 adults without secure email use between July 2010 and July 2012 matched to users on demographics, health status, and baseline utilisation. PRIMARY OUTCOME MEASURES: Rates of office visits, patient-initiated phone calls, scheduled telephone visits, after-hours clinic visits, emergency department visits, and hospitalisations. RESULTS: After controlling for multiple factors, no statistically significant differences in utilisation between secure email users and non-users occurred. Utilisation transiently increased by 88–237% around first email use. Annual rates of patient-initiated phone calls decreased among secure email users, 0.2 fewer calls per person (95% CI −0.3 to −0.1), from a mean of 4.1 calls per person 1–12 months before first use to a mean of 3.8 calls per person 7–18 months after first use. Rates of patient-initiated phone calls also decreased among non-users, 0.1 fewer calls per person (95% CI −0.2 to 0.0), from a mean of 4.2 calls per person 1–12 months before the index date to mean of 4.1 calls per person 7–18 months after the index date. CONCLUSIONS: Compared with non-users, patient use of secure email with clinicians was not associated with statistically significant differences in clinical services utilisation 7–18 months after first use. BMJ Publishing Group 2015-11-09 /pmc/articles/PMC4654385/ /pubmed/26553841 http://dx.doi.org/10.1136/bmjopen-2015-009557 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Health Informatics Meng, Di Palen, Ted E Tsai, Joanne McLeod, Melanie Garrido, Terhilda Qian, Heather Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study |
title | Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study |
title_full | Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study |
title_fullStr | Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study |
title_full_unstemmed | Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study |
title_short | Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study |
title_sort | association between secure patient–clinician email and clinical services utilisation in a us integrated health system: a retrospective cohort study |
topic | Health Informatics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654385/ https://www.ncbi.nlm.nih.gov/pubmed/26553841 http://dx.doi.org/10.1136/bmjopen-2015-009557 |
work_keys_str_mv | AT mengdi associationbetweensecurepatientclinicianemailandclinicalservicesutilisationinausintegratedhealthsystemaretrospectivecohortstudy AT palentede associationbetweensecurepatientclinicianemailandclinicalservicesutilisationinausintegratedhealthsystemaretrospectivecohortstudy AT tsaijoanne associationbetweensecurepatientclinicianemailandclinicalservicesutilisationinausintegratedhealthsystemaretrospectivecohortstudy AT mcleodmelanie associationbetweensecurepatientclinicianemailandclinicalservicesutilisationinausintegratedhealthsystemaretrospectivecohortstudy AT garridoterhilda associationbetweensecurepatientclinicianemailandclinicalservicesutilisationinausintegratedhealthsystemaretrospectivecohortstudy AT qianheather associationbetweensecurepatientclinicianemailandclinicalservicesutilisationinausintegratedhealthsystemaretrospectivecohortstudy |