Joy L. Lee, PhD, assistant professor at Indiana University School of Medicine and a research scientist at the Regenstrief Institute, talks about how technology is helping to make check-ups with your doctor easier.
Wanted to ask you, Dr. Lee, for starters, why you and your colleagues became interested in this particular topic.
LEE: So, communication is something that we are all doing electronically now, texting, using Instagram is a big part of our everyday lives. So we were curious two – about two questions. First, are these trends reflected in health care? That the – does the convenience of technology and communication translate over to health care? And we were also interested in, if people are using these things – using technology, are they talking to their providers about it? And we were interested in that question specifically because this is – health care using technology to communicate is still a relatively new area, so there isn’t a lot of guidance for patients and not a lot of guidance for doctors. But one of the few things that all the experts recommend is that it’s important to have a conversation between patients and doctors about using technology before they start. So before you start emailing your doctor, you should talk about it ahead of time so that you both have the same set of expectations. So given that this is something that all the experts recommend, we wanted to see, does this actually happen in real life?
What did you and your colleagues look at in particular?
LEE: We surveyed respondents in the state of Indiana, people who lived all across 34 different counties in the state of Indiana, and we asked them questions that we were interested in like, do you use email? Do you use patient portals? Do you use social media to talk to your doctor? Have you done that in the last year? Have you ever talked to your doctor about information you find online? So, these types of what we call information-seeking behavior and health information technology use – this was part of a larger survey that was also interested in cancer screening behaviors and cancer knowledge in the state of Indiana, so there were also questions about that. And also, just some demographic questions about people’s age, their education level, so we understand who these respondents are that are taking the survey.
And what did you find? What numbers started coming back?
LEE: Sure. So we found that a little less than half of the people had used some sort of technology to communicate with their doctors in the last year, about 47% had either used patient portals which is sort of the secure email through electronic health records system, or – they used that or email or even social media and texting and video to talk to their doctors. The most common thing people used was this patient portal – the secure email through electronic health records system.
Now, did that number surprise you or did you and your colleagues think that was about what you were going to find?
LEE: So I think it was about what we expected in that about half the people had used some sort of technology, although we were surprised – or I was surprised that about 20% of people said they had texted their doctor in the last year. So the different types of things people used surprised me in that what was popular versus what was not. But the overall trend that a little less than half the people – that was in line with some national – or previous studies that we had seen.
In your mind, does this leave a lot of room for change? If you only have about half of people communicating this way, what’s everybody – what are the other patients doing to get a hold of their doctor?
LEE: Oh, definitely. I would say that this number – the roughly 48% tells us that there is room for improvement. Now, we’re not necessarily looking at 100% because not every patient necessarily needs to talk to their doctor within one year using using some sort of technology. And some people just might prefer not to. But we think that, given how widely available this technology is, that if only about half the people are using it, clearly some people don’t know about it. Some people know that it exists but are not comfortable yet using it. So, there is definitely room for improvement.
What is the – what are the benefits to having this communication available?
LEE: Well, I think the huge benefit of health information technology, especially when it comes to messaging your doctor or looking up your health information online, is the same convenience of just looking stuff up online and texting that we find in our everyday lives. It’s convenient. It’s something that you can do in your own time, in your own home without playing phone tag with your doctor. And it also, very important in health care in that you can see the information or you can have a record of your conversation with your doctor, and I find that to be a very valuable aspect of messaging with your doctor because, for me, personally, sometimes when I’m talking to my doctor, I’m in the zone. But once I go home, I completely forget what specialized term they use. But with this messaging, I can either ask them a question of – what was that medication that you had said again? Or I could look it up in my record and see what the doctor’s note said.
And I don’t know whether this research was begun before COVID, so I don’t know whether it impacted it all. But having that communication – that availability – is that more important even more now so these days than before?
LEE: Yeah, so this survey was done before COVID and we think that, if we were to do the same survey again, we would probably see big differences. And one area in particular was that only two percent of the people who responded to our survey said they had used some sort of video to communicate with their doctor in the last year. Now that number, with COVID and with people not being able to show up to clinics in person, I think we’re seeing drastic increases in telemedicine, in telehealth, in virtual care. So I think that’s a number that will definitely change because of COVID.
Is that a concern for anyone in texting, e-mailing, rather than just calling? Were there privacy concerns? And how do people get around those?
LEE: Right, so that’s something that a minority of patients are definitely concerned about. In our survey, we did ask people, if you didn’t use these ways to communicate, what was your reason why not? And about five to 10% of people consistently said because of privacy issues. So I think there are some things that individuals can do to protect their privacy. There are also things that health care institutions can do to protect their privacy. There are some ways of communicating using technology that’s safer than others. For example, patient portals are a much more secure way than texting or using your personal email address. But the tradeoff for that is that it requires an extra login. There’s – it’s a less convenient way. So these are risks and benefits that patients have to weigh themselves.
Is there anything I didn’t ask you that you would want to make sure people know about this body of research?
LEE: I would really recommend patients to ask their doctors about messaging them electronically.
Is that something the doctor’s office – is that something that the office offers? Is that something the doctor themself likes to do? If they do message, what is the expected turnaround time? What types of…
LEE: Issues are appropriate for messaging. I think that’s something that patients don’t necessarily think about because we think, oh, texting and email, I know how to use that. But health care brings different concerns and it’s a slightly different ballgame. So, it’s something that we all have to learn a little bit and adapt to. So it’s a conversation that’s worth having.
And then, Dr. Lee, how long have you studied this issue?
LEE: So, this is something that I’ve been doing for the past five to seven years.
Have you seen, even in that time, changes in the number of people that communicate via email – by text?
LEE: In the past, I would say five years, we see that the use of email has gone down a little bit as patient portals – as a more secure preferred way that is promoted by health care institutions has become more widely available. And I think that’s a great thing – that the secure way is more available to patients – to a wider number of people. And because the portal comes with not just messaging – the email is only for messaging. But with the portal you can also have access to your record, you can refill medications a lot of times. So the patient portal, I think, is a great tool, but it’s a tool that health care institutions can also still improve, there are many more ways that they can use to make it more user friendly and that they can educate patients on its availability.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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Joy L. Lee
317-643-2313
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