Large-Scale Survey Findings Shed Light on Secure Messaging User Experiences
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Abstract
Background: The United States Department of Veterans Affairs has implemented an electronic asynchronous Secure Messaging tool within a web-based patient portal (ie, My HealtheVet). Secure Messaging is part of a national transformation initiative to create New Models of Care to support patient-provider communication and promote self-care management. Large-scale research is needed to determine Secure Messaging user profiles and evaluate their experiences using this communication tool.
Objective: This presentation reports findings of a large-scale quantitative survey to shed light on who opts to use Secure Messaging and their experiences using this tool to communicate with their health care team in an integrated healthcare system.
Methods: Qualitative findings from a mixed-methods study (in-depth interviews, user-testing, secondary Secure Messaging data review, and follow-up phone interviews) with veterans (n= 33) were used to develop and implement a quantitative survey with a random sample of respondents (n=819) who were registered to use Secure Messaging. The survey collected demographic data, assessed computer and health literacy and Secure Messaging use. Analyses conducted on survey data included, frequencies and proportions, Chi-Square tests, and one-way ANOVAS.
Results: Most survey respondents reported everyday use of computer (n=662, 80.8%) and internet (n=653, 79.7%). The majority of respondents reported using the Secure Messaging tool 6 months or longer (n=499, 60.9%). Most participants (486, 59.3%) reported using Secure Messaging at least once a year, while 131 (16.0%) reported using it at least once a month. Respondents reported finding Secure Messaging helpful for completing medication refills (n=546, 66.7%), medication questions (n=313, 38.2%), managing appointments (n=343, 41.9%), test results (n=350, 42.7%), and health related questions (n=340, 41.5%). Notably, some respondents reported using Secure Messaging to address sensitive health topics (n=67, 8.2%). Individuals with marginal and adequate health literacy reported higher levels of satisfaction (p-value=0.002), ease of use (p-value=0.001), usefulness (p-value=0.023) and were more likely to perceive secure messaging as a secure form of communication (p-value=0.001), compared to those with inadequate health literacy. Respondents with higher Computer-Email-Web Fluency Scale (CEW) and e-Health Literacy Scale (eHeals) scores were more likely report higher levels of use (p-value<0.001), ease of use (p-value<0.05) and satisfaction using Secure Messaging (p-value<0.001). Other demographic and usage group comparisons will be reviewed during the presentation. Notably, many respondents (n=328, 40.0%) reported that they would like education and/or support on how to use MyHealtheVet and Secure Messaging to manage their health care; and the vast majority of respondents felt other Veterans would benefit from education on how to access and use MyHealtheVet and Secure Messaging (n=652, 79.6%).
Conclusion: Overall, survey findings indicate respondents perceive Secure Messaging as a useful tool for communicating with health care teams. Frequency of use, perceptions of ease of use and satisfaction differs by socio-demographic factors such as education, income, and health literacy and eHealth literacy levels. Marketing targeting user/non-user groups, educational instruction, and system modifications are needed to maximize sustained utilization of Secure Messaging. These survey findings can inform ongoing and future efforts to maximize the use of this tool for patient-provider communication and self-care management.
Objective: This presentation reports findings of a large-scale quantitative survey to shed light on who opts to use Secure Messaging and their experiences using this tool to communicate with their health care team in an integrated healthcare system.
Methods: Qualitative findings from a mixed-methods study (in-depth interviews, user-testing, secondary Secure Messaging data review, and follow-up phone interviews) with veterans (n= 33) were used to develop and implement a quantitative survey with a random sample of respondents (n=819) who were registered to use Secure Messaging. The survey collected demographic data, assessed computer and health literacy and Secure Messaging use. Analyses conducted on survey data included, frequencies and proportions, Chi-Square tests, and one-way ANOVAS.
Results: Most survey respondents reported everyday use of computer (n=662, 80.8%) and internet (n=653, 79.7%). The majority of respondents reported using the Secure Messaging tool 6 months or longer (n=499, 60.9%). Most participants (486, 59.3%) reported using Secure Messaging at least once a year, while 131 (16.0%) reported using it at least once a month. Respondents reported finding Secure Messaging helpful for completing medication refills (n=546, 66.7%), medication questions (n=313, 38.2%), managing appointments (n=343, 41.9%), test results (n=350, 42.7%), and health related questions (n=340, 41.5%). Notably, some respondents reported using Secure Messaging to address sensitive health topics (n=67, 8.2%). Individuals with marginal and adequate health literacy reported higher levels of satisfaction (p-value=0.002), ease of use (p-value=0.001), usefulness (p-value=0.023) and were more likely to perceive secure messaging as a secure form of communication (p-value=0.001), compared to those with inadequate health literacy. Respondents with higher Computer-Email-Web Fluency Scale (CEW) and e-Health Literacy Scale (eHeals) scores were more likely report higher levels of use (p-value<0.001), ease of use (p-value<0.05) and satisfaction using Secure Messaging (p-value<0.001). Other demographic and usage group comparisons will be reviewed during the presentation. Notably, many respondents (n=328, 40.0%) reported that they would like education and/or support on how to use MyHealtheVet and Secure Messaging to manage their health care; and the vast majority of respondents felt other Veterans would benefit from education on how to access and use MyHealtheVet and Secure Messaging (n=652, 79.6%).
Conclusion: Overall, survey findings indicate respondents perceive Secure Messaging as a useful tool for communicating with health care teams. Frequency of use, perceptions of ease of use and satisfaction differs by socio-demographic factors such as education, income, and health literacy and eHealth literacy levels. Marketing targeting user/non-user groups, educational instruction, and system modifications are needed to maximize sustained utilization of Secure Messaging. These survey findings can inform ongoing and future efforts to maximize the use of this tool for patient-provider communication and self-care management.
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