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

Ming Huang; Aditya Khurana; George Mastorakos; Andrew Wen; Huan He; Liwei Wang; Sijia Liu; Yanshan Wang; Nansu Zong; Julie Prigge; Brian Costello; Nilay Shah; Henry Ting; Jungwei Fan; Christi Patten; Hongfang Liu

doi:10.2196/35187

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

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

Authors

Ming Huang¹, Aditya Khurana², George Mastorakos², Andrew Wen¹, Huan He¹, Liwei Wang¹, Sijia Liu¹, Yanshan Wang¹, Nansu Zong¹, Julie Prigge³, Brian Costello³, Nilay Shah¹, Henry Ting⁴, Jungwei Fan¹, Christi Patten^{5

6}, Hongfang Liu¹

Affiliations

¹ Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, United States.
² Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, United States.
³ Center for Connected Care, Mayo Clinic, Rochester, MN, United States.
⁴ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
⁵ Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States.
⁶ Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.

PMID: 35171108
PMCID: PMC9084445
DOI: 10.2196/35187

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.

©Ming Huang, Aditya Khurana, George Mastorakos, Andrew Wen, Huan He, Liwei Wang, Sijia Liu, Yanshan Wang, Nansu Zong, Julie Prigge, Brian Costello, Nilay Shah, Henry Ting, Jungwei Fan, Christi Patten, Hongfang Liu. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 05.05.2022.

Abstract

Grants and funding