A large number of surveyed patients with chronic conditions who exchanged secure email with providers via Kaiser Permanente’s patient portal reported that the communications improved their overall health status.

The study is dated; it was conducted in 2011 and finally published in recent days in the American Journal of Managed Care. All the processes of research, findings, writing up a study and waiting to get published can take a considerable amount of time, says Mary Reed, a staff scientist in Kaiser’s research unit.

However, the results remain relevant today, she adds, in part because Kaiser launched its patient portal in 2006 so use of it was mature when the survey of 1,041 patients was conducted—just as under the Meaningful Use program many patient portals used today have become mature. Yet, there remain many other providers today still in the learning stage when it comes emailing with patients who should take note of the survey.

Also See: Challenges Ahead for Portals

The survey queried patients who had used the Kaiser portal to send messages to providers, and those who had not. Surveys were conducted by mail, online or by telephone interview “to ensure that access to technology would not affect response rates,” according to Kaiser.

One-third of respondents said exchanging email improved their overall health, confirming the effort to offer email was worth it, says Reed of Kaiser. “I mean, that’s the whole reason we’re in this, to improve health.” Two-thirds said portal emailing it did not change overall health and less than one percent said emailing made their health worse.

The most surprising finding, Reed says, is that many patients used the portal email function as their first method of contact with a provider. Researchers had expected first contact to be made to an existing provider about health concerns. Money also played a strong role. Among email users, 85 percent of patients with higher cost sharing used email as the first contact, compared with 63 percent with lower cost sharing. Patients were defined as having overall higher cost sharing if they reported a deductible or co-pays of at least $60 for an office visit.

In the survey, 42 percent of those emailing said it reduced phone calls and 36 percent said it reduced in-person visits. That demonstrates increased physician productivity while lowering the use of more expensive in-office visits, Reed acknowledges.


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