title: Secure Messaging in Electronic Health Records and Its Impact on Diabetes Clinical Outcomes: A Systematic Review.
abstract: In 2009, President Barack Obama signed into law the Health Information Technology for Economic and Clinical Health (HITECH) Act, which aims for the universal adoption of electronic health records (EHRs) in primary care settings and "meaningful use" of this technology. The objectives of "meaningful use" are well defined and executed in stages; one of the objectives of stage 2, beginning in 2014, was implementation of a secure messaging system between patients and providers. Secure messaging has been shown to positively affect patients who struggle with managing chronic diseases on a day to day basis. This review aims to assess the clinical evidence supporting the use of secure messaging in EHRs in self-management of diabetes.
  
  
  
  A systematic search of PubMed was conducted, and 320 results were returned. Of these, 11 were selected based on outlined criteria.
  
  
  
  Evidence from 7 of the 11 included studies suggests significant improvement in patients' hemoglobin A1c (HbA1c) with the use of secure messaging. However, improvements in patients' secondary outcomes, such as blood pressure and cholesterol, were inconsistent. Further work must be done to determine how to best maximize the potential of available tools such as secure messaging and EHRs to improve patient outcomes.
authors.affiliation: 1 University of Miami , Coral Gables, Florida.
authors.forename: Alyce
authors.initials: A
authors.lastname: Kuo
authors.affiliation: 2 Miami VA Healthcare System Geriatric, Research Education and Clinical Center and Extended Care and Research Services , Miami, Florida.|3 Division of Geriatrics and Palliative Care, Department of Medicine, University of Miami Miller School of Miami , Miami, Florida.
authors.forename: Stuti
authors.initials: S
authors.lastname: Dang
mesh_terms: D001794:Blood Pressure; D016494:Computer Security; D003920:Diabetes Mellitus / Q000628:therapy*; D057286:Electronic Health Records / Q000458:organization & administration*; D006442:Glycated Hemoglobin; D006801:Humans; D008055:Lipids / Q000097:blood; D062527:Meaningful Use; D000073278:Self-Management / Q000379:methods*; D017216:Telemedicine / Q000379:methods
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids
keywords: e-health; education; home health monitoring; medical records; telehealth