Electronic Messaging Use via a Patient Portal Is Associated with Primary Care Utilization in Patients with Type 2 Diabetes

Background: Electronic messaging via a patient portal is being used with increasing frequency for patient-provider communication, especially for the ongoing management of type 2 diabetes (T2DM). Providing patients online access to providers may reduce the need for face-to-face contact; yet little is known about the usage pattern and its association with the frequency of office visits to primary care providers (PCP). Methods: A cross-sectional analysis was conducted using the data from the ambulatory electronic health records of UPMC Physician Services. Adults with T2DM who were seen in UPMC PCP offices between Jan 2015 and Dec 2016 were included. The number of days messaging was used, and the number of PCP visits for each patient were calculated during the study period. Descriptive statistics were applied. Negative binomial regression was performed to examine the association of messaging use with the number of PCP visits, adjusting for age, gender, race, education, income, insurance type, and the number of comorbidities. Results: The sample (N=42,746) was 85.5% white and 49.9% female with a mean age of 65.2±11.9 years. About a third (36.7%, n=15,698) used the messaging feature at least once during the study period. The median number of days that patients used the messaging feature was 13.0 (range 1-395). Negative binomial regression revealed that greater use of messaging was associated with a greater number of PCP visits (Incidence Rate Ratio 1.0014, 95% CI, 1.0011-1.0018). Conclusion: In our study, over one-third of the patients used the messaging feature via the portal. More frequent use of messaging was associated with a greater number of PCP visits, suggesting that both measures represent patient engagement in health care services. However, the frequency of PCP visits may not be an accurate indicator of clinical outcomes. Future studies that include patient outcome measures, such as HbA1c, according to portal use are needed as use of this technology increases. Disclosure R. Sun: None. S.M. Sereika: None. M. Saul: None. M.T. Korytkowski: Advisory Panel; Self; Novo Nordisk Inc.. Other Relationship; Self; JAEB Center For Health Research. D. Li: None. L.E. Burke: None.