Patient use of secure electronic messaging within a shared medical record: a cross-sectional study.

Background: Most patients would like to be able to exchange electronic messages with personal physicians. Few patients and providers are exchanging electronic communications.

Objective: To evaluate patient characteristics associated with the use of secure electronic messaging between patients and health care providers.

Design, Setting, And Patients: Cross-sectional cohort study of enrollees over 18 years of age who were enrolled in an integrated delivery system in 2005.

Measurements And Main Results: Among eligible enrollees, 14% (25,075) exchanged one or more secure messages with a primary or specialty care provider between January 1, 2004 and March 31, 2005. Higher secure messaging use by enrollees was associated with female gender (OR, 1.15; 95% CI, 1.10-1.19), greater overall morbidity (OR, 5.64; 95% CI, 5.07-6.28, comparing high or very high to very low overall morbidity), and the primary care provider's use of secure messaging with other patients (OR, 1.94; 95% CI, 1.67-2.26, comparing 20-50% vs.
Conclusions: In this integrated group practice, use of patient-provider secure messaging varied according to individual patient clinical and sociodemographic characteristics. Future studies should clarify variation in the use of electronic patient-provider messaging and its impact on the quality and cost of care received.