Doctor-Patient E-mail Improves Outcomes in Hypertension and Diabetes

Communicating with patients via secure e-mail can improve outcomes in hypertension and diabetes. Researchers at Kaiser Permanente who studied more than 35,000 patients with diabetes, hypertension, or both reported that “use of secure patient-physician messaging in any two-month period was associated with statistically significant improvements in HEDIS (Healthcare Effectiveness Data and Information Set) care measurements.”

Kaiser Permanente reports that patients who participated in the study experienced “2.0 percentage-points to 6.5 percentage-points improvements in glycemic, cholesterol and blood pressure screening and control.”

During the study, researchers monitored more than 556,000 secure patient-physician e-mail threads, containing more than 630,000 messages. They reported that more than 85% of e-mail communications were initiated by patients; physicians received between 2-12 messages per day and spent an average of 3.5 minutes responding to each message.

The Kaiser press release notes that previous research conducted by Kaiser Permanente among patients who use Kaiser’s My Health Manager personal health record found that “75 percent of all patient-physician e-mail encounters addressed ongoing medical problems or care plans. The leading reasons patients contact physicians are to discuss changes in a health condition, lab test results, a new condition, drug dosage adjustments, or the need for a new prescription.”

According to Kaiser, “This study is one of the first to show that these electronic communications have a measurable positive effect on patient outcomes, in addition to improving efficiency. Kaiser Permanente physicians participating in the study reported that the use of secure e-mail messaging has been highly successful for diabetes patients, enabling them to follow medical instructions to the letter. Physicians also are encouraging patients to schedule an appointment if they raise issues via e-mail that are too complex or lengthy to address using that medium.”

Michael Kanter, MD, co-author of the study and regional medical director of quality and clinical analysis, Southern California Permanente Medical Group, said that “It is important to keep the lines of communication open, while not inconveniencing patients by playing phone tag or bringing them into the office unnecessarily.” Secure e-mail messaging “is a huge patient satisfier and an efficient way of handling many routine care issues,” said Kantor.

Results from this study were published in the July issue of Health Affairs.