Secure messaging and COVID-19: an analysis of the content of patient-clinician communication during the pandemic

Télémed JE Santé. November 11, 2021. doi: 10.1089 / daily.2021.0316. Online ahead of print.

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) had an immediate impact on patient-clinician communication, particularly in the context of oncology. At the same time, the use of secure messaging (SM) has increased dramatically, but it is not known what was discussed and whether the technology was used to disseminate the information. Goals : This study aimed to identify the topics most frequently discussed using SM as well as understand how the communication process unfolded during the early stages of the pandemic. Materials and methods: A mixed-method design was used, consisting of a content analysis of over 4,200 secure messages, grouped into 1,454 patient-clinician discussions. Data was collected from February 2020 to May 2020. Discussions took place in various oncology departments and included physicians, physician assistants and nurses. Based on the categories identified, a thematic analysis was carried out to understand the nuances appearing in the discussions. Results: Of the 1,454 discussions, 26% (m = 373) linked to COVID-19. From the COVID-19 discussion, the most frequently coded category was ‘changes, adjustments and reorganization of care’ (65%, m = 241), followed by “risk of COVID-19” (24%, m = 90), “precautions inside the hospital” (18%, m = 66), and “out-of-hospital precautions” (14%, m = 52). Natural language processing techniques were used to confirm the validity of the results. The thematic analysis found that patients were proactive in rescheduling appointments, expressed anxiety about being immunosuppressed, and clinicians were unsure of providing recommendations related to COVID-19. Conclusion: The COVID-19 outbreak has revealed the need for responsive and effective public health communication. The MS can disseminate information from trusted sources, clinicians, but can be better used to provide personalized information for specific patient populations.

PMID: 34767741 | DOI: 10.1089 / tmj.2021.0316