T. S. Raghu, Ph.D., Arizona State University
Keith Frey, MD, MBA, Dignity Health
Yu-Hui Chang, PhD, Mayo Clinic, Arizona
Meng-Ru Cheng MSPH, Takeda Development Center North Americas, Inc.
Sharon Freimund, Mayo Clinic, Arizona
Asha Patel, Mayo Clinic, Arizona

This study analyzed patient adoption of secure messaging to update medication list in an ambulatory care setting. The objective was to establish demographic differences between users and non-users of secure messaging for medications list update. Efficiency of secure messaging for the updates was compared to fax and telephone based updates. The study used a retrospective, cross-sectional study of patient medical records and pharmacy call logs at Mayo Clinic, Arizona from December 2012 to May 2013, approximately one year after organizing a pharmacy call center for medication updates. A subgroup analysis during a 2-week period was used to measure time to complete update. A total of 22,495 outpatient visits were drawn and 18,702 unique patients were included in the primary analysis. A total of 402 unique patients were included in sub-group analysis. Secure message response rate (49.5%) was statistically significantly lower than that for phone calls (54.8%, p<0.001). Time to complete the update was significantly higher for faxed medication lists (Wilcoxon rank-sum tests, p<0.001) when compared to those for secure message or phone. In summary, around 50% of the patients respond to medication update requests before office visit when contacted using phone calls and secure messages. Given the demographic differences between users and non-users of patient portal, mixed mode communication with patients is likely to be the norm for the foreseeable future in outpatient settings.


T. S. Raghu, Keith Frey, Yu-Hui Chang, Meng-Ru Cheng, M.S., Sharon Freimund, Asha Patel, “Using secure messaging to update medications list in ambulatory care setting.” International Journal of Medical Informatics, 2015, 84(10), 754-762.