title: Timely response to secure messages from primary care patients.
abstract: OBJECTIVE
  To assess delays in response to patient secure e-mail messages in primary care.
  
  
  BACKGROUND
  Secure electronic messages are initiated by primary care patients. Timely response is necessary for patient safety and quality.
  
  
  METHODS
  A database of secure messages.
  
  
  METHODS
  A random sample of 353 secure electronic messages initiated by primary care patients treated in 4 clinics.
  
  
  METHODS
  Message not opened after 12 hours or messages not responded to after 36 hours.
  
  
  RESULTS
  A total of 8.5% of electronic messages were not opened within 12 hours, and 17.6% did not receive a response in 36 hours. Clinic location, being a clinic employee, and patient sex were not related to delays. Patients older than 50 years were more likely to receive a delayed response (25.7% delayed, P = .013). The risk of both kinds of delays was higher on weekends (P < .001 for both).
  
  
  CONCLUSIONS
  The e-mail message system resulted in high rates of delayed response. Delays were concentrated on weekends (Friday-Sunday). Reducing delayed responses may require automatic rerouting of messages to message centers staffed 24-7 or other mechanisms to manage this after-hours work flow.
authors.affiliation: Department of Family Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. rohrer.james@mayo.edu
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
authors.forename: Frederick
authors.initials: F
authors.lastname: North
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Angstman
authors.forename: Sara S
authors.initials: SS
authors.lastname: Oberhelman
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Meunier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D034742:Electronic Mail / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D011787:Quality of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult