Introduction: Secure messaging is a platform for email communication between patients and their physicians. Although patient-generated emails are associated with increased use of clinical services, greater member retention, and improved quality of care, secure messaging has a marked impact on primary care physicians' workload.
Objective: To understand how the email topic and volume vary by demographics and clinical factors among members of a managed care organization.
Methods: We analyzed all secure messages sent to primary care departments by adult members of Kaiser Permanente Southern California (KPSC) in 2017.
Results: Members with a higher volume of office visits and telephone appointment visits generated a higher volume of emails to primary care physician. Members with a Centers of Medicare and Medicaid Services Hierarchical Condition Category diagnosis history sent 3 times as many emails as those without such a diagnosis history. Women accounted for nearly two-thirds of emails despite making up only half of the KPSC member population. Less than one-fourth (21.4%) of members sent 2.3 million total emails to their physician. Medical advice was the most common reason for sending secure messages (24.7%) in a sample studied (n = 2397).
Discussion: These findings confirm the need for additional research to more accurately quantify the additional burden from secure message utilization on primary care physicians. Knowing the factors associated with secure messaging usage and message content could assist in building more efficient staffing models and creating more efficient routing that matches the message content with a physician's scope of practice.