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. 2022 May 5;9(2):e35187.
doi: 10.2196/35187.

Patient Portal Messaging for Asynchronous Virtual Care During the COVID-19 Pandemic: Retrospective Analysis

Ming Huang  1 , Aditya Khurana  2 , George Mastorakos  2 , Andrew Wen  1 , Huan He  1 , Liwei Wang  1 , Sijia Liu  1 , Yanshan Wang  1 , Nansu Zong  1 , Julie Prigge  3 , Brian Costello  3 , Nilay Shah  1 , Henry Ting  4 , Jungwei Fan  1 , Christi Patten  5   6 , Hongfang Liu  1
Affiliations

Patient Portal Messaging for Asynchronous Virtual Care During the COVID-19 Pandemic: Retrospective Analysis

Ming Huang et al. JMIR Hum Factors. .

Abstract

Background: During the COVID-19 pandemic, patient portals and their message platforms allowed remote access to health care. Utilization patterns in patient messaging during the COVID-19 crisis have not been studied thoroughly. In this work, we propose characterizing patients and their use of asynchronous virtual care for COVID-19 via a retrospective analysis of patient portal messages.

Objective: This study aimed to perform a retrospective analysis of portal messages to probe asynchronous patient responses to the COVID-19 crisis.

Methods: We collected over 2 million patient-generated messages (PGMs) at Mayo Clinic during February 1 to August 31, 2020. We analyzed descriptive statistics on PGMs related to COVID-19 and incorporated patients' sociodemographic factors into the analysis. We analyzed the PGMs on COVID-19 in terms of COVID-19-related care (eg, COVID-19 symptom self-assessment and COVID-19 tests and results) and other health issues (eg, appointment cancellation, anxiety, and depression).

Results: The majority of PGMs on COVID-19 pertained to COVID-19 symptom self-assessment (42.50%) and COVID-19 tests and results (30.84%). The PGMs related to COVID-19 symptom self-assessment and COVID-19 test results had dynamic patterns and peaks similar to the newly confirmed cases in the United States and in Minnesota. The trend of PGMs related to COVID-19 care plans paralleled trends in newly hospitalized cases and deaths. After an initial peak in March, the PGMs on issues such as appointment cancellations and anxiety regarding COVID-19 displayed a declining trend. The majority of message senders were 30-64 years old, married, female, White, or urban residents. This majority was an even higher proportion among patients who sent portal messages on COVID-19.

Conclusions: During the COVID-19 pandemic, patients increased portal messaging utilization to address health care issues about COVID-19 (in particular, symptom self-assessment and tests and results). Trends in message usage closely followed national trends in new cases and hospitalizations. There is a wide disparity for minority and rural populations in the use of PGMs for addressing the COVID-19 crisis.

Keywords: COVID-19; asynchronous communication; digital health; health care; healthcare; pandemic; patient portal; patient portal message; remote healthcare; utilization; virtual care.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Daily numbers and weekly smoothing averages (WSAs) of patient-generated messages (PGMs) related to COVID-19.
Figure 2
Figure 2
Daily numbers and weekly smoothing averages (WSAs) of patient-generated messages (PGMs) regarding COVID-19–related care (diagnosis and treatment): (A) COVID-19 symptom assessment via self-checker, (B) COVID-19 symptom assessment by providers via e-visits, (C) discussions regarding COVID-19 tests and results, and (D) care plans.
Figure 3
Figure 3
Daily numbers and weekly smoothing averages (WSAs) of patient-generated messages (PGMs) regarding COVID-19–related other health care issues: (A) general issues due to COVID-19, (B) postponement, (C) cancellation, (D) anxiety, (E) depression, and (F) suicidal ideation.
See this image and copyright information in PMC

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