Industry works toward improving secure messaging for EHRs

Is health illiteracy among patients getting in the way of enhanced patient engagement?

Enhanced communication between doctors and their patients will greatly improve patient engagement across the health care industry. This is essential, as a more efficient, secure transfer of health data between patients and their providers will lead to high-quality care on a nationwide level. The ability for patients and their physicians to send one another secure messages electronically is a crucial advancement that the sector has to make before it can fully achieve patient engagement. 

Secure messaging has clear benefits 
Patient engagement is one of the three main changes that the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT have been working toward since the 2009 Health Information Technology for Economic and Clinical Health Act was passed. The other two include interoperability and an increase in the number of health professionals who adopt electronic health records. 

Providers should take advantage of electronic messaging with their patients to encourage patient engagement within their practices or facilities. In fact, the CMS even requires providers to do so under the stage 2 and 3 meaningful use standards.

Why has the CMS and ONC been pushing the industry toward greater use of secure messaging? It has a variety of benefits, which include closely monitoring chronic health conditions and their symptoms, improving care coordination and providing patients with immediate answers to their health-related questions. Secure messaging can also serve as an effective platform for prescription refills and similar processes that would normally require an appointment to complete. 

Health literacy may prove to be an obstacle
A recent study published in the Journal of the American Medical Informatics Association pointed to one specific challenge that providers may run into when using their EHR systems to enhance communication with patients. The researchers found that there is a large gap in the health literacy levels among the patient population. This would get in the way of many of the benefits that the industry could see from secure messaging. 

The study included the examination of 31 email exchanges – 119 messages – between providers from a primary clinic and their patients. The researchers assessed how readable the messages were. The goal was to identify possible strategies to improve the quality of the communication efforts. 

"Patients used more words in their initial emails compared to providers, but the FKGLs [Flesch-Kincaid Grade Levels] were similar, and 68 percent of provider messages were written below an FKGL = 8. Of 31 exchanges, 9 [29 percent] contained at least one patient message with an FKGL > 3 grade levels lower than the corresponding provider message(s)," the researchers stated in their findings. "Our study demonstrates that most providers are able to respond to patient electronic messages with a matching reading level."

Giving patients access to necessary health information when they are not at their doctor's office is essential to improving care and streamlining various procedures like processing drug refills and providing test results. 

Farzad Mostashari, former head of the ONC, explained to EHR Intelligence that while providing patients with access to their medical records and relevant health data is essential to enhancing care quality, the industry needs to consider what happens after the population receives this information. Will they be able to interpret it? If not, patient engagement will fail to improve the health of the patient population like it is expected to do. 

As patient engagement and interoperability continue to top the list of improvements the health care continuum is working toward, it becomes increasingly crucial that health professionals start asking themselves this question. If providers fail to do so, the sector may never see significant outcomes from pushing tools like secure messaging and patient portals.