J. Med. Internet Res. - Evaluating user experiences of the secure messaging tool on the Veterans Affairs' patient portal system.

Tópicos

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Resumo

CKGROUND: The United States Department of Veterans Affairs has implemented an electronic asynchronous "Secure Messaging" tool within a Web-based patient portal (ie, My HealtheVet) to support patient-provider communication. This electronic resource promotes continuous and coordinated patient-centered care, but to date little research has evaluated patients' experiences and preferences for using Secure Messaging.OBJECTIVE: The objectives of this mixed-methods study were to (1) characterize veterans' experiences using Secure Messaging in the My HealtheVet portal over a 3-month period, including system usability, (2) identify barriers to and facilitators of use, and (3) describe strategies to support veterans' use of Secure Messaging.METHODS: We recruited 33 veterans who had access to and had previously used the portal's Secure Messaging tool. We used a combination of in-depth interviews, face-to-face user-testing, review of transmitted secure messages between veterans and staff, and telephone interviews three months following initial contact. We assessed participants' computer and health literacy during initial and follow-up interviews. We used a content-analysis approach to identify dominant themes in the qualitative data. We compared inferences from each of the data sources (interviews, user-testing, and message review) to identify convergent and divergent data trends.RESULTS: The majority of veterans (27/33, 82%) reported being satisfied with Secure Messaging at initial interview; satisfaction ratings increased to 97% (31/32, 1 missing) during follow-up interviews. Veterans noted Secure Messaging to be useful for communicating with their primary care team to manage health care needs (eg, health-related questions, test requests and results, medication refills and questions, managing appointments). Four domains emerged from interviews: (1) perceived benefits of using Secure Messaging, (2) barriers to using Secure Messaging, (3) facilitators for using Secure Messaging, and (4) suggestions for improving Secure Messaging. Veterans identified and demonstrated impediments to successful system usage that can be addressed with education, skill building, and system modifications. Analysis of secure message content data provided insights to reasons for use that were not disclosed by participants during interviews, specifically sensitive health topics such as erectile dysfunction and sexually transmitted disease inquiries.CONCLUSIONS: Veterans perceive Secure Messaging in the My HealtheVet patient portal as a useful tool for communicating with health care teams. However, to maximize sustained utilization of Secure Messaging, marketing, education, skill building, and system modifications are needed. Data from this study can inform a large-scale quantitative assessment of Secure Messaging users' experiences in a representative sample to validate qualitative findings.

Resumo Limpo

ckground unit state depart veteran affair implement electron asynchron secur messag tool within webbas patient portal ie healthevet support patientprovid communic electron resourc promot continu coordin patientcent care date littl research evalu patient experi prefer use secur messagingobject object mixedmethod studi character veteran experi use secur messag healthevet portal month period includ system usabl identifi barrier facilit use describ strategi support veteran use secur messagingmethod recruit veteran access previous use portal secur messag tool use combin indepth interview facetofac usertest review transmit secur messag veteran staff telephon interview three month follow initi contact assess particip comput health literaci initi followup interview use contentanalysi approach identifi domin theme qualit data compar infer data sourc interview usertest messag review identifi converg diverg data trendsresult major veteran report satisfi secur messag initi interview satisfact rate increas miss followup interview veteran note secur messag use communic primari care team manag health care need eg healthrel question test request result medic refil question manag appoint four domain emerg interview perceiv benefit use secur messag barrier use secur messag facilit use secur messag suggest improv secur messag veteran identifi demonstr impedi success system usag can address educ skill build system modif analysi secur messag content data provid insight reason use disclos particip interview specif sensit health topic erectil dysfunct sexual transmit diseas inquiriesconclus veteran perceiv secur messag healthevet patient portal use tool communic health care team howev maxim sustain util secur messag market educ skill build system modif need data studi can inform largescal quantit assess secur messag user experi repres sampl valid qualit find

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