title: The Next Frontier in Communication and the ECLIPPSE Study: Bridging the Linguistic Divide in Secure Messaging.
abstract: Health systems are heavily promoting patient portals. However, limited health literacy (HL) can restrict online communication via secure messaging (SM) because patients' literacy skills must be sufficient to convey and comprehend content while clinicians must encourage and elicit communication from patients and match patients' literacy level. This paper describes the Employing Computational Linguistics to Improve Patient-Provider Secure Email (ECLIPPSE) study, an interdisciplinary effort bringing together scientists in communication, computational linguistics, and health services to employ computational linguistic methods to (1) create a novel Linguistic Complexity Profile (LCP) to characterize communications of patients and clinicians and demonstrate its validity and (2) examine whether providers accommodate communication needs of patients with limited HL by tailoring their SM responses. We will study >5 million SMs generated by >150,000 ethnically diverse type 2 diabetes patients and >9000 clinicians from two settings: an integrated delivery system and a public (safety net) system. Finally, we will then create an LCP-based automated aid that delivers real-time feedback to clinicians to reduce the linguistic complexity of their SMs. This research will support health systems' journeys to become health literate healthcare organizations and reduce HL-related disparities in diabetes care.
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Dean
authors.identifier: 0000-0002-7221-7327
authors.initials: D
authors.lastname: Schillinger
authors.affiliation: Arizona State University, Tempe, AZ, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: McNamara
authors.affiliation: Georgia State University, Atlanta, GA, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Crossley
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Courtney
authors.identifier: 0000-0002-1111-8595
authors.initials: C
authors.lastname: Lyles
authors.affiliation: Kaiser Permanente, Oakland, CA, USA.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Moffet
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Urmimala
authors.initials: U
authors.lastname: Sarkar
authors.affiliation: Arizona State University, Tempe, AZ, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Duran
authors.affiliation: Kaiser Permanente, Oakland, CA, USA.
authors.forename: Jill
authors.identifier: 0000-0003-3635-6423
authors.initials: J
authors.lastname: Allen
authors.affiliation: Kaiser Permanente, Oakland, CA, USA.
authors.forename: Jennifer
authors.identifier: 0000-0002-9702-7415
authors.initials: J
authors.lastname: Liu
authors.affiliation: Redwood Community Health Coalition, Petaluma, CA, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Oryn
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Neda
authors.identifier: 0000-0001-9944-6923
authors.initials: N
authors.lastname: Ratanawongsa
authors.affiliation: Kaiser Permanente, Oakland, CA, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Karter
mesh_terms: D003142:Communication; D003924:Diabetes Mellitus, Type 2; D057286:Electronic Health Records; D034742:Electronic Mail; D057220:Health Literacy; D006801:Humans; D020407:Internet; D010817:Physician-Patient Relations