title: Using secure messaging to update medications list in ambulatory care setting.
abstract: This study analyzed patient adoption of secure messaging to update medication list in an ambulatory care setting. The objective was to establish demographic differences between users and non-users of secure messaging for medications list update. Efficiency of secure messaging for the updates was compared to fax and telephone based updates.
  
  
  METHODS
  The study used a retrospective, cross-sectional study of patient medical records and pharmacy call logs at Mayo Clinic, Arizona from December 2012 to May 2013, approximately one year after organizing a pharmacy call center for medication updates. A subgroup analysis during a 2-week period was used to measure time to complete update.
  
  
  METHODS
  Main dependent variable is the frequency of medication list updates over the study duration. Technician time required for the update was also utilized.
  
  
  RESULTS
  A total of 22,495 outpatient visits were drawn and 18,702 unique patients were included in the primary analysis. A total of 402 unique patients were included in sub-group analysis. Secure message response rate (49.5%) was statistically significantly lower than that for phone calls (54.8%, p<0.001). Time to complete the update was significantly higher for faxed medication lists (Wilcoxon rank-sum tests, p<0.001) when compared to those for secure message or phone.
  
  
  CONCLUSIONS
  Around 50% of the patients respond to medication update requests before office visit when contacted using phone calls and secure messages. Given the demographic differences between users and non-users of patient portal, mixed mode communication with patients is likely to be the norm for the foreseeable future in outpatient settings.
authors.affiliation: Department of Information Systems, W. P. Carey School of Business, Arizona State University, BA 304C, Tempe, AZ 85287, United States. Electronic address: Raghu.Santanam@asu.edu.
authors.forename: T S
authors.initials: TS
authors.lastname: Raghu
authors.affiliation: Chief Physician Executive, Arizona Service Area, Dignity Health, 3030 N Central Avenue, Suite 1402, Phoenix, AZ 85012, United States.
authors.forename: Keith
authors.initials: K
authors.lastname: Frey
authors.affiliation: Division of Health Sciences Research, Mayo Clinic, Arizona, 13400 E Shea Blvd., Scottsdale, AZ 85259, United States.
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chang
authors.affiliation: Takeda Development Center North Americas, Inc., One Takeda Parkway, Deerfield, IL 60015, United States.
authors.forename: Meng-Ru
authors.initials: MR
authors.lastname: Cheng
authors.affiliation: Information Technology, Mayo Clinic, Arizona, 13400 E Shea Blvd., Scottsdale, AZ 85259, United States.
authors.forename: Sharon
authors.initials: S
authors.lastname: Freimund
authors.affiliation: Pharmacy, Mayo Clinic, Arizona, 13400 E Shea Blvd., Scottsdale, AZ 85259, United States.
authors.forename: Asha
authors.initials: A
authors.lastname: Patel
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001130:Arizona / Q000453:epidemiology; D003219:Confidentiality; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D059065:Medication Reconciliation / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data; D017678:Sex Distribution; D055815:Young Adult; D016903:Drug Monitoring
keywords: Ambulatory care facilities; Clinical pharmacy services; Medication reconciliation; Patient portal; Secure messaging