Abstract
Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide
are working to integrate the use of Secure Messaging (SM) into care delivery and identify
innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA
clinical care team members and veterans.
Objectives A collaborative project solicited input from VA clinical care teams about their local
practices using SM to provide access to proactive patient-centered care for veterans
and enhance workflow.
Methods This project implemented a single-item cross-sectional qualitative electronic survey
via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks
(VISNs). Content analysis was used to manage descriptive data responses. Descriptive
statistics described sample characteristics.
Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire.
Content analysis of 171 responses produced two global domains: (1) benefits of SM
and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication
and increased access to care. Care team members incorporate SM into their daily clinical
practices, using it to provide services before, during, and after clinical encounters
as a best practice. SM users suggest improvements in veteran care, clinical team workflow,
and efficient use of health resources. Clinical team members invested in the successful
implementation of SM integrate SM into their daily practices to provide meaningful
and useful veteran-centered care and improve workflow.
Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical
team members within the VA system can replicate best practices shared by other clinical
care teams to generate meaningful and useful interactions with SM to enrich veterans'
health care experience.
Keywords
patient provider communication - messaging - ambulatory care/primary care - process
improvement - diffusion of innovation
