Just under 60 percent of patient portals with secure messaging lack instructions for how patients can use messaging appropriately.

That’s one of the findings of a new research endeavor conducted by Regenstrief Institute and Indiana University School of Medicine. While the study reports that most hospitals now offer portals that patients can use to access their personal health information, many have failed to explain how to go about using the portals correctly, especially in regard to electronic messaging.

“Patient portals with secure messaging allow patients to connect directly with their care team, though it only works and is thus only appropriate if someone is reading the messages on the other end,” Dr. Joy L. Lee, a Regenstrief Institute research scientist and Indiana University School of Medicine assistant professor, told HCB News. “If the care team uses it, then secure messaging is appropriate for many circumstances. Monitoring a patient's progress is one good example, say, if a doctor wanted to see if a new medication was working for a patient, and wanted to get updates on a patient's blood pressure over a short period, messages checking in would be one way that's convenient.”
The number of healthcare providers adopting portals has increased significantly over the past 10 years, with the government awarding financial incentives to those that do offer patients access to the technology. The monetary award is issued in accordance with a federal law known as the Health Information Technology for Economic and Clinical Health (HITECH) Act.

But clinicians have expressed concerns over the misuse of portals, especially electronic messaging, while patients have indicated a desire for more instructions on how to use portals and secure messaging, according to the study, which analyzed information from a random sample of 200 acute-care hospitals in the U.S.

Lee and her colleagues relied on publicly available portal information from hospitals' websites for their assessment, and consulted hospitals for additional information distributed to patients about portals and messaging.

While they found 89 percent to be in possession of a patient portal, only 60 percent included secure messaging. Of those with secure messaging, 58 percent lacked details of how a patient is supposed to use messaging. For instance, though many included disclaimers that specified messaging was not to be used in emergencies, 23 providers included such notices under “Terms and Conditions”, a section that few patients may actually read.

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