Physicians’ Experiences Using Secure Messaging for Diabetes Management: A Qualitative Study
Notice bibliographique
Résumé
Background: The COVID-19 pandemic led to increased demand for remote management of type 2 diabetes using secure messaging, or patient-provider text-based communication. Prior research on secure messaging has described the content of messages sent for type 2 diabetes management and demonstrated its impact on clinical outcomes. However, there is a gap in knowledge about how secure messaging performs as a communication medium for specific tasks in clinical care (eg, prescription management and discussing medical questions). Additional research is needed to understand physicians' experiences using secure messaging to communicate with patients about clinical tasks that support diabetes management. Objective: This study aims to investigate physicians' experience using secure messaging to communicate with patients about specific clinical tasks for type 2 diabetes management. Methods: We interviewed a sample of endocrinologists and internists from 2 different medical facilities who have used secure messaging to communicate with adult patients about type 2 diabetes management. Semistructured interviews were used to solicit physicians' experience using secure messaging for 6 specific tasks that support diabetes management: refilling prescriptions, answering nonurgent medical questions, scheduling appointments, discussing test results, making referral requests, and discussing visit follow-up. Interviews were conducted until we achieved saturation of themes for these tasks. Interview data were collected between 2021 and 2023. Qualitative data were analyzed using the framework method for thematic analysis. Results: We interviewed 6 internists and 4 endocrinologists (n=10). Physicians reported spending between 2 and 5 hours per day messaging with patients. They observed that secure messaging increased the frequency and timeliness of communication, which improved care coordination and facilitated care delivery between visits. This served as a time-efficient way to iterate specific components of treatment plans, including discussing test results, visit follow-up, scheduling, and prescription refill. Physicians were frustrated with the unstructured nature of secure messages. Patients wrote messages that were often disorganized, confusing, or did not have enough information for the provider to take action. This often made answering nonurgent medical questions difficult. In many cases, poorly structured secure messages resulted in lengthy back-and-forth communications between patients and physicians, which sometimes required a phone call or an office visit to resolve. Conclusions: Physicians reported that secure messaging supports a longitudinal model of care, where patients can iterate their treatment plan between visits. For tasks with well-defined information boundaries, such as scheduling and prescription refill, physicians reported that secure messaging improved the time efficiency of care delivery. Providers experienced challenges using secure messaging for more complex tasks and often reported not receiving sufficient clinical information. We identified a demand for workflow technologies to process incoming secure messages to improve clarity and ensure that messages have sufficient information to inform decisions on the best course of action.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».