Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?
Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees.



A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital.



All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P < .001 and r = 0.543, P < .001). The remaining clinics were not significantly correlated but demonstrated a weak positive correlation (r = 0.098, P = .560 and r = 0.069, P = .671).



Implementation and increased use of electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload.
From the Department of Family Medicine, Oregon Health & Science University, Portland (ED, SF, RER, DY, MM); the Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health & Science University, Portland (MM); and the Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland (BS). dextere@ohsu.edu.
Eve N
EN
Dexter
From the Department of Family Medicine, Oregon Health & Science University, Portland (ED, SF, RER, DY, MM); the Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health & Science University, Portland (MM); and the Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland (BS).
Scott
S
Fields
From the Department of Family Medicine, Oregon Health & Science University, Portland (ED, SF, RER, DY, MM); the Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health & Science University, Portland (MM); and the Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland (BS).
Rebecca E
RE
Rdesinski
From the Department of Family Medicine, Oregon Health & Science University, Portland (ED, SF, RER, DY, MM); the Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health & Science University, Portland (MM); and the Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland (BS).
Bhavaya
B
Sachdeva
From the Department of Family Medicine, Oregon Health & Science University, Portland (ED, SF, RER, DY, MM); the Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health & Science University, Portland (MM); and the Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland (BS).
Daisuke
D
Yamashita
From the Department of Family Medicine, Oregon Health & Science University, Portland (ED, SF, RER, DY, MM); the Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health & Science University, Portland (MM); and the Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland (BS).
Miguel
M
Marino
D003142:Communication; D057286:Electronic Health Records; D034742:Electronic Mail / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D009922:Oregon; D000072638:Patient Portals; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012189:Retrospective Studies; D013689:Telephone / Q000706:statistics & numerical data*
Communication; Electronic Health Records; Health Personnel; Information Systems; Internet; Motivation; Retrospective Studies; Telephone; Workload