Characterizing the Users of Patient Portal Messaging: A Single Institutional Cohort Study

This work studied message communications on patient portals and examined both the longitudinal trends and the correlations with characteristics of message senders. We analyzed over 5.6 million secure messages sent on the Mayo Clinic patient portal between February 18, 2010, and December 31, 2017. We studied the longitudinal changes in the number of portal messages, patient senders' demographics and medical conditions (PheCodes), and provider senders' care settings (e.g., primary or specialty) and practice roles (e.g., physician, nurse practitioner, and registered nurses). When compared to non-message-senders, patient message senders had a significantly higher proportion of the demographics: age 41-60, female, married, white, and English-speaking. From 2010-2017, an individual patient sent an average of 9.8 messages per person while a provider sent 418.4. The average number of PheCodes for all patients regardless of portal usage increased from 7.5 +/-6.9 in 2010 to 10.7 +/- 10.1 in 2017. The Pearson correlation coefficient between average PheCodes per patient and average messages per patient was 0.273 (p < 0.0001). Physicians were the largest proportion of message composers in both primary and specialty care (36.20% of primary, 37.54% of specialty). Starting 2013 onwards, specialty providers comprised the majority of portal providers while primary care providers remained stable around 20-22%. Our results show that patient portals are playing an increasingly significant role in supporting patient-provider communications. The longitudinal growth also sheds light on the possible challenge of communication overload for providers and the healthcare system.