Using secure messaging to update medications list in ambulatory care setting

• We assess differences between users and non-users of secure messaging for medications list update.
• Overall, secure message response rate was significantly lower than that for phone call based requests.
• Response rate was highest among patients aged 41–70 and lowest among patients aged over 70.
• The time to complete medication list update was similar for secure messaging and phone call requests.
• Mixed mode communication with patients should continue to be the norm in outpatient settings.

This study analyzed patient adoption of secure messaging to update medication list in an ambulatory care setting. The objective was to establish demographic differences between users and non-users of secure messaging for medications list update. Efficiency of secure messaging for the updates was compared to fax and telephone based updates.MethodsThe study used a retrospective, cross-sectional study of patient medical records and pharmacy call logs at Mayo Clinic, Arizona from December 2012 to May 2013, approximately one year after organizing a pharmacy call center for medication updates. A subgroup analysis during a 2-week period was used to measure time to complete update.Main measuresMain dependent variable is the frequency of medication list updates over the study duration. Technician time required for the update was also utilized.ResultsA total of 22,495 outpatient visits were drawn and 18,702 unique patients were included in the primary analysis. A total of 402 unique patients were included in sub-group analysis. Secure message response rate (49.5%) was statistically significantly lower than that for phone calls (54.8%, p < 0.001). Time to complete the update was significantly higher for faxed medication lists (Wilcoxon rank-sum tests, p < 0.001) when compared to those for secure message or phone.ConclusionsAround 50% of the patients respond to medication update requests before office visit when contacted using phone calls and secure messages. Given the demographic differences between users and non-users of patient portal, mixed mode communication with patients is likely to be the norm for the foreseeable future in outpatient settings.