Patient Use of the Electronic Communication Portal in Management of Type 2

Abstract

The high incidence and prevalence of Type 2 Diabetes require urgent attention to the management of this chronic disease. Previous studies present the advantages of e-communication via the patient portal to access Electronic Medical Records (EMR) by patients. The purpose of this study was to explore e-communication between patients with Type 2 Diabetes and their providers within the patient portal in one of the Midwest healthcare systems. The study employed a qualitative design, based on the use of content analysis methods. Conversation Theory served as the theoretical framework. A purposive, random sample of 90 charts of patients with Type 2 Diabetes in a Midwestern health system was subjected to a retrospective review of the e-communication within the patient portal. The sample consisted of patients between the ages of 50 and 70, the majority of whom were White, Non-Hispanic, English-speaking, and married. Patients were described as receiving good care, with the mean duration of Diabetes at 8.41 years. Patients were also relatively experienced in using the patient portal. The three main themes that emerged in the e-communication via patient portal were the Inform Theme, the Question Theme, and the Instruct/Request Theme. The Inform theme was the most frequently identified; the Instruct/Request Theme was mainly used in initiation of e-communication. The Question Theme was the least frequently observed of the three themes in e-message encounters. The fit with Conversation Theory revealed that most of the staff-initiated e-message encounters fit within the monolog type, while most of the patient-initiated e-message encounters fit within the dialogue type. Dialectic and construction types of conversation were very rare. Limitations of the study include the bias of the researcher, and lack of certain data in EMR. There is a need to develop standardized templates for Type 2 Diabetes e-communication via patient portal to capture complete data from the patients, and to promote diabetes education via patient portal using a construction type of conversation. Healthcare system guidelines should include information about the initiation and the use of e-communication via patient portal, and specifically target engaging patients who are not meeting desired diabetes care outcomes.