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Secure asynchronous messaging: the future of patient portals?




Asynchronous messaging is a type of communication in which messages are exchanged between parties without requiring real-time interaction. In asynchronous messaging, participants can send and receive messages at their own pace, without the need for immediate response.

Asynchronous messaging can take many forms, such as email, SMS, messaging apps, or forums. Each participant can compose a message and send it to the other party, who can then receive and respond to the message at a later time. This allows for greater flexibility and control over when and how communication takes place.

One of the main benefits of asynchronous messaging is that it can reduce the need for real-time communication, which can be particularly useful when participants are located in different time zones or have different schedules. Asynchronous messaging also allows participants to carefully consider their messages and respond in a more thoughtful and deliberate manner.

However, asynchronous messaging can also have some drawbacks. For example, the lack of immediate feedback or response can make it more difficult to establish a sense of rapport or build trust with others. Additionally, if participants are not diligent in checking their messages and responding in a timely manner, it can lead to delays in decision-making or project completion.

Overall, asynchronous messaging is a useful tool for communication in many contexts, but it should be used strategically and in conjunction with other forms of communication to achieve the best possible outcomes.


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Asynchronous messaging in healthcare


Asynchronous messaging has the potential to improve healthcare communication by enabling healthcare professionals to exchange messages and information at their own convenience, without having to be physically present or available at the same time. This can be particularly useful in situations where immediate response is not necessary, but timely communication is still important.

Here are some examples of how asynchronous messaging can be used in healthcare:

  1. Patient-provider communication: Patients can use asynchronous messaging to communicate with their healthcare providers for non-urgent issues, such as medication refills, appointment scheduling, and test results. This can reduce the need for in-person visits or phone calls, which can be time-consuming and inconvenient.

  2. Consultations and referrals: Healthcare providers can use asynchronous messaging to consult with other specialists or refer patients to other providers. This can speed up the referral process and reduce the need for in-person consultations.

  3. Team communication: Asynchronous messaging can be used to facilitate communication among members of a healthcare team, such as nurses, physicians, and pharmacists. This can help ensure that everyone is on the same page regarding patient care and can improve the coordination of care.

  4. Education and training: Asynchronous messaging can be used for educational purposes, such as sharing clinical guidelines, research findings, or case studies. It can also be used for training purposes, such as providing feedback on clinical skills or sharing instructional videos.

  5. Care coordination: Asynchronous messaging can be used to coordinate care between healthcare providers and other stakeholders, such as family members, caregivers, or social workers. This can help ensure that all parties are informed and involved in the care process.

Overall, asynchronous messaging can be a valuable tool for improving healthcare communication and coordination, particularly in settings where face-to-face interactions may not be feasible or necessary. However, it is important to ensure that privacy and security measures are in place to protect patient information.


What are the main advantages of asynchronous messaging in healthcare?


Asynchronous messaging in healthcare has several advantages, including:

  1. Improved accessibility: Asynchronous messaging allows healthcare providers and patients to communicate with each other at any time, from anywhere, as long as they have access to a computer or mobile device. This can increase the accessibility of healthcare services and reduce barriers to care.

  2. Time efficiency: Asynchronous messaging eliminates the need for real-time communication, which can save time for both healthcare providers and patients. For example, a patient can send a message to their healthcare provider about a non-urgent issue and receive a response at a later time that is convenient for both parties, without having to schedule an in-person appointment or phone call.

  3. Increased patient engagement: Asynchronous messaging can improve patient engagement by providing patients with a convenient way to communicate with their healthcare providers. Patients may be more likely to ask questions or share concerns when they can do so at their own pace and from the comfort of their own homes.

  4. Enhanced coordination of care: Asynchronous messaging can facilitate the exchange of information between healthcare providers, which can improve the coordination of care. For example, a primary care physician can send a message to a specialist with information about a patient's condition, and the specialist can respond with recommendations for treatment or further testing.

  5. Cost savings: Asynchronous messaging can help reduce healthcare costs by eliminating the need for in-person visits or phone calls. Patients may also be more likely to seek care for non-urgent issues if they can communicate with their healthcare providers in a convenient and cost-effective way.

  6. Improved patient satisfaction: Asynchronous messaging can enhance patient satisfaction by providing patients with a convenient way to communicate with their healthcare providers and by increasing their engagement in their own care. Patients may also appreciate the flexibility and convenience of asynchronous messaging compared to traditional forms of communication.

Overall, asynchronous messaging can improve healthcare communication, coordination, and accessibility while also reducing costs and improving patient satisfaction. However, it is important to ensure that privacy and security measures are in place to protect patient information.


What are the main disadvantages of asynchronous messaging in healthcare?


While asynchronous messaging can offer several advantages in healthcare, there are also some potential disadvantages to consider, including:

  1. Miscommunication: Asynchronous messaging may lead to miscommunication if messages are not clear or if important information is left out. This can be particularly problematic in situations where immediate response is necessary, or when complex medical information is being discussed.

  2. Security and privacy concerns: Asynchronous messaging can pose security and privacy risks if messages are not adequately protected or if patient information is shared inappropriately. It is important to ensure that appropriate security measures are in place to protect patient information.

  3. Lack of personal connection: Asynchronous messaging can create a lack of personal connection between healthcare providers and patients. Patients may feel more comfortable discussing sensitive information in person or over the phone, rather than through messaging.

  4. Inability to conduct physical exams: Asynchronous messaging may not be suitable for situations that require physical exams or assessments. Healthcare providers may need to conduct in-person visits or refer patients to specialists for further evaluation.

  5. Legal and regulatory concerns: The use of asynchronous messaging in healthcare may raise legal and regulatory concerns related to medical liability, informed consent, and documentation requirements. Healthcare providers should be aware of these concerns and ensure that they are complying with applicable laws and regulations.

Overall, while asynchronous messaging can offer several advantages in healthcare, it is important to carefully consider the potential disadvantages and to implement appropriate measures to address them. It may not be suitable for all types of healthcare communication and should be used in conjunction with other forms of communication as needed.



Clinical Evidence: secure asynchronous messaging in healthcare

An interesting study entitled "Patient portal messaging for care coordination: a qualitative study of perspectives of experienced users with chronic conditions" by Jennifer L. Hefner, Sarah R. MacEwan, Alison Biltz & Cynthia J. Sieck has highlighted the importance of secure asynchronous messaging as potentially the future of patient portals.


Introduction to the Study

Patient portal secure messaging (asynchronous electronic communication between physicians and their established patients) allows patients to manage their care through asynchronous, direct communication with their providers.


This type of engagement with health information technology could have important benefits for patients with chronic conditions, and a more thorough understanding of the use and barriers of secure messaging among this population is needed.


The objective of this study was to explore how experienced portal users engage with secure messaging to manage their chronic conditions.

Results of the Study

Patients’ motivation for using messaging included the speed and ease of such communication and direct access to a physician. Messaging was used by patients as an extension of the office visit and supported coordination of care among providers as well as patient collaboration with family members or caretakers.


Patients identified challenges to using messaging, including technological barriers, worry about uncompensated physician time spent responding to messages, and confusion about what constitutes an appropriate ‘non-urgent’ message.

Conclusions of the Study

This study highlights the potential of patient portal messaging as a tool for care coordination to enhance chronic disease self-management. However, uncertainty about the appropriate use of portal messaging persists even among experienced users.


Additional patient training in the proper use of secure messaging and its benefits for disease self-management may help to resolve these concerns.



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Thoughts, comments? Tweet @lloydgprice, or email lloyd@healthcare.digital and let's start a conversation :)


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