The relationship that a clinician has with a patient may have a greater impact on patient satisfaction than any technology that used to interact with one another, according to new research.
A new study led by Joy L. Lee, Ph.D., of the Regenstrief Institute's Center for Health Services Research compares these ways to communicate, compared how patients and their healthcare providers communicate with one another outside the clinic or doctor's office, specifically looking at how patients and their physicians feel about email, cell phone and text interactions.
The study, published in the European Journal for Person Centered Healthcare, also looked into provider concerns, finding that physicians worried most about patients potentially missing urgent messages, as well as possible patient misunderstanding of information contained in electronic messages. Clinicians were also concerned about the amount of time they spent on electronic communication with patients, and about data security, although both ranked lower.
Data for the study was obtained via a 16-question survey of 149 primary care providers (internists, family medicine physicians and pediatricians) in community practice in 2012 to 2013 that was linked to provider satisfaction scores.
Use of a cell phone by clinicians to communicate with patients was higher than use of email. Fewer than half of the clinicians participating in the study used email to communicate with patients, but 70 percent indicated that they would use it to reply if a patient emailed them first.
The work was conducted in the year prior to clinic implementation of a new electronic health record (EHR) system with secure patient-messaging capabilities. Although secure messaging, the function of an EHR which ensures that only patients and their providers can access the communication, was not a part of the study, there are implications for clinicians who use secure messaging and their patients.
"With the move to secure messaging by health systems and medical groups, it's no longer just about adoption, Lee said. “It’s about how we address patient and physician concerns to make electronic communication work for both."
Ineffective or insufficient communication has been shown in previous studies to diminish patient satisfaction as well as adherence to physician orders. Patient-physician communication is often worse with patients with poor health according to Lee.
"It's time that doctor and patient have a face-to-face conversation during an office visit explaining how each feels about electronic communication," said. Lee. "Patients can discuss their electronic access and their comfort level with getting information electronically. Physicians can share their own concerns with patients."
Added Lee, "The takeaway message about secure messaging? Physicians who have a stronger relationship with their patients and who let their patients know how to contact them either online or off may have better patient satisfaction than those who do not. This is a conversation doctors and their patients should have."
Lee has previously researched e-communication guidelines for patients and providers, coming to the conclusion that the guidelines need to be modernized.