Secure Messaging Associated With More In-Office Visits, Study Finds

July 16, 2014 in News

Increased use of secure messaging among patients with diabetes during and after a redesign of patient-center medical homes was associated with a slight uptick in office visits, according to a study published in the Annals of Family Medicine, FierceHealthIT reports (Hall, FierceHealthIT, 7/15).

Study Details

The study examined the use of secure messaging and telephone calls without copayments by 18,486 diabetic adults. Researchers analyzed the patients’ use of secure messaging and telephone calls before, during and after the implementation of a patient-centered medical home at 26 Group Health primary care clinics (Terry, Medscape, 7/15).

Group Health had offered patients such modes of communication for several years before the study, the researchers noted. All patients involved in the study had health insurance and were of relatively high socioeconomic status, according to the report (FierceHealthIT, 7/15).

Study Findings

Overall, the study found that patients’ use of secure messaging and telephone calls to communicate with their physicians increased steadily during the study period, while office visits decreased by 8%.

However, an adjusted analysis showed that a 10% increase in patients’ use of secure message threads was associated with a 1.25% increase in office visits.

The researchers concluded, “Our observational results … do not support the hypothesis that, in general, chronically ill patients will use new forms of copay-free communication as an alternative to in-person visits” (MedScape, 7/15).

They explained, “Although secure messaging and telephone encounters may facilitate patients’ self-management of diabetes, they cannot fully substitute for clinical tasks such as in-person foot and eye examinations and physical examinations” (FierceHealthIT, 7/15).


Rosemarie Nelson, a health IT consultant for the Medical Group Management Association, noted that secure messaging has never been a replacement for office visits among patients with chronic illnesses and “nobody’s ever suggested that.”

She added, “People with diabetes know that their feet have to be looked at and their eyes have to be examined” (Medscape, 7/15).

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