--- title: "Can secure patient-provider messaging improve diabetes care? | Sutter Health" description: "Pts with diabetes frequently used messaging for medical advice in addition to routine visits. Messaging was positively associated with better diabetes mgmt." url: "https://www.sutterhealth.org/research/publications/secure-pt-provider-messaging-improve-diabetes-care-1055312308" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Can secure patient-provider messaging improve diabetes care? # Can secure patient-provider messaging improve diabetes care? Chung S, Panattoni L, Chi J, & Palaniappan L. _Diabetes Care. pii: dc170140. doi: 10.2337/dc17-0140. \[Epub ahead of print\]_ 2017-08-14 ## Abstract OBJECTIVE: Internet-based secure messaging between patients and providers through a patient portal is now common in the practice of modern medicine. There is limited evidence on how messaging is associated with use and clinical quality measures among patients with type 2 diabetes. We examine whether messaging with physicians for medical advice is associated with fewer face-to-face visits and better diabetes management. RESEARCH DESIGN AND METHODS: Patients with diabetes who were enrolled in an online portal of an outpatient health care organization in 2011-2014 were studied (N = 37,762 patient-years). Messages from/to primary care physicians or diabetes-related specialists for medical advice were considered. We estimated the association of messaging with diabetes quality measures, adjusting for patient and provider characteristics and patient-level clustering. RESULTS: Most patients (72%) used messaging, and those who made frequent visits were also more likely to message. Given visit frequency, no (vs. any) messaging was negatively associated with the likelihood of meeting an HbA1c target of <8% (64 mmol/mol) (odds ratio \[OR\] 0.83 \[95% CI 0.77, 0.90\]). Among message users, additional messages (vs. 1) were associated with better outcome (two more messages: OR 1.17 \[95% CI 1.06, 1.28\]; three more messages: 1.38 \[1.25, 1.53\]; four more messages: 1.55 \[1.43, 1.69\]). The relationship was stronger for noninsulin users. Message frequency was also positively associated, but to a smaller extent, with process measures (e.g., eye examination). Physician-initiated messages had effects similar to those for patient-initiated messages. CONCLUSIONS: Patients with diabetes frequently used secure messaging for medical advice in addition to routine visits to care providers. Messaging was positively associated with better diabetes management in a large community outpatient practice. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/28807977) ## Research topics - [Diabetes, Insulin Resistance and Metabolic Syndrome](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Diabetes%2C+Insulin+Resistance+and+Metabolic+Syndrome%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Patients' medication-related experience of care is associated with adherence to cardiometabolic disease therapy in real-world clinical practice.](https://www.sutterhealth.org/research/publications/pt-experience-of-care-associated-with-cmd-tx-adherence-1055312299) Romanelli RJ, Huang Q, LaMori J, Doshi D, Chung S. Popul Health Manag. doi: 10.1089/pop.2017.0163. \[Epub ahead of print\] 2018 Mar 12 - Publication ### [Patient-initiated electronic messages and quality of care for patients with diabetes and hypertension in a large fee-for-service medical group: results from a natural experiment.](https://www.sutterhealth.org/research/publications/e-messages-qual-of-care-pts-dm-htn-1055312360) McClellan SR, Panattoni L, Chan AS, Tai-Seale M. Med Care. \[Epub ahead of print\] 2016 Jan 12 - Publication ### [Pharmacist-led medication management program within a patient-centered medical home.](https://www.sutterhealth.org/research/publications/pharmacist-led-medication-management-in-pcmh-1055312959) Romanelli RJ, Leahy A, Jukes T, Ishisaka DY. Am J Health Syst Pharm. 72(6):453-9. doi: 10.2146/ajhp140487. 2015 Mar 15 - Publication ### [Cost estimates for designing and implementing a novel team care model for chronically ill patients.](https://www.sutterhealth.org/research/publications/cost-estimates-to-design-implement-chronic-care-model-1055312334) Panattoni L, Dillon E, Hurlimann L, Durbin M, Tai-Seale M. J Ambul Care Manage. doi: 10.1097/JAC.0000000000000209. \[Epub ahead of print\] 2017 Sep 25 - Publication ### [Workflow standardization of a novel team care model to improve chronic care: a quasi-experimental study.](https://www.sutterhealth.org/research/publications/std-workflow-team-care-model-improve-chronic-care-1055312331) Panattoni L, Hurlimann L, Wilson C, Durbin M, Tai-Seale M. BMC Health Serv Res. 2017 Apr 19;17(1):286. doi: 10.1186/s12913-017-2240-1. 2017 Apr 19 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/secure-pt-provider-messaging-improve-diabetes-care-1055312308#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Can secure patient-provider messaging improve diabetes care?"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/secure-pt-provider-messaging-improve-diabetes-care-1055312308#medicalscholarlyarticle","name":"Can secure patient-provider messaging improve diabetes care?","headline":"Can secure patient-provider messaging improve diabetes care?","abstract":"OBJECTIVE: Internet-based secure messaging between patients and providers through a patient portal is now common in the practice of modern medicine. There is limited evidence on how messaging is associated with use and clinical quality measures among patients with type 2 diabetes. We examine whether messaging with physicians for medical advice is associated with fewer face-to-face visits and better diabetes management. RESEARCH DESIGN AND METHODS: Patients with diabetes who were enrolled in an online portal of an outpatient health care organization in 2011-2014 were studied (N = 37,762 patient-years). Messages from/to primary care physicians or diabetes-related specialists for medical advice were considered. We estimated the association of messaging with diabetes quality measures, adjusting for patient and provider characteristics and patient-level clustering. RESULTS: Most patients (72%) used messaging, and those who made frequent visits were also more likely to message. Given visit frequency, no (vs. any) messaging was negatively associated with the likelihood of meeting an HbA1c target of \u003c8% (64 mmol/mol) (odds ratio [OR] 0.83 [95% CI 0.77, 0.90]). Among message users, additional messages (vs. 1) were associated with better outcome (two more messages: OR 1.17 [95% CI 1.06, 1.28]; three more messages: 1.38 [1.25, 1.53]; four more messages: 1.55 [1.43, 1.69]). The relationship was stronger for noninsulin users. Message frequency was also positively associated, but to a smaller extent, with process measures (e.g., eye examination). Physician-initiated messages had effects similar to those for patient-initiated messages. CONCLUSIONS: Patients with diabetes frequently used secure messaging for medical advice in addition to routine visits to care providers. Messaging was positively associated with better diabetes management in a large community outpatient practice.","description":"Pts with diabetes frequently used messaging for medical advice in addition to routine visits. 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