Table 1 Patient-reported motivations and uses of secure messaging for disease management

Motivations for using messaging

Representative comment

Quicker than calling the office

“I'd rather do that [send a portal message] and wait … I’d rather wait that way as opposed to someone telling me [on the phone] they can’t see me until December.”

“Well it saves the phone call, the message, the phone call back.”

“I know that was in the morning, by the noontime I had heard from her via the telephone and she had made arrangements for me to get in to see another doc in this practice so they could do urine specimen but I was able to get some meds quick.”

“It’s a lot quicker [than the phone].”

Direct access to a physician

“Saves phone calls, saves this kind of messages from having to go from who answers the phone to the doctor.”

“My doctor, she’s really good at checking her email. She says she tries to get in between each person she sees…to see if she has anything new. Which is nice, you know she replies pretty fast.”

“I didn’t want to call the office to go through the gatekeeper, so I wrote [a portal message] hoping that my doctor would read that today.”

Uses of messaging for care management

Representative comment

Extension of the office visit

“It’s mostly kind of just instead of having to come in for an appointment every week.”

“Like if I’m sending a message like this, it’s not something where I’m like ‘I really need to know this right now.’ It’s like, 'Oh hey I thought about this, this is something I don’t want to have like schedule an appointment, I would just like to know the answer sooner rather than later.'”

Coordination of care

“The other thing I love doing it [sending secure messages] for is sometimes I don’t know what doctor to go to, I was seeing so many specialists I really didn’t know. So, I would go to like my doctor since she was managing my care and say, ‘Who do you feel comfortable with me asking, you know going to?’ And she would always just respond right back and say, ‘You should go to your cardiologist for that,’ or pulmonologist or whatever so that was really helpful.”

“After my initial appointment she said you know, she would send me messages about how she set me up for appointments with the neurologist, cardiac, um and a lung test, um some type of test.”

“For instance, I’m having a dental procedure done in May and I might have to stop a blood thinner. I’m just going to email my family doctor and say, 'I need your approval that this is okay, you respond to this MyChart message, I'll print it out and I’ll give it to the guy doing the surgery.'”