William G. Weppner|James D. Ralston|Thomas D. Koepsell|Louis C. Grothaus|Robert J. Reid|Luesa Jordan|Eric B. Larson
Use of a Shared Medical Record With Secure Messaging by Older Patients With Diabetes
University of Washington|Kaiser Permanente Washington Health Research Institute|University of Washington|Kaiser Permanente Washington Health Research Institute|Kaiser Permanente Washington Health Research Institute|Kaiser Permanente Washington Health Research Institute|Kaiser Permanente Washington Health Research Institute
evaluate use webbased shared medical record smr older patients diabetes providersthis retrospective cohort study health records smr use patterns 6185 enrollees aged 65 years diabetes analyzed implementation smr august 2003 december 2007 analyzed baseline predictors age sex distance clinic socioeconomic status insulin use morbidity associated primary care providers pcp secure messaging use patients initial subsequent use smr changes morbidity pcp diabetes treatment evaluated impact outcomesa total 322 enrollees used smr median rate 102 userdaysmonth numbers users rate use continued increase adjusted analyses likelihood smr use associated younger age male sex higher socioeconomic status neighborhood well clinical characteristics overall morbidity assigned pcps use secure messaging initial smr use likely within 3 months increase morbidity hazard ratio 161 95 ci 128201 within 1 month changing pcp higher use 302 166551four years implementation onethird older individuals diabetes used webbased smr higher morbidity predicted initial continued use smr services providers use communication feature associated higher likelihood smr engagement patients webbased smrs may effective form nonvisitbased health care older individuals diabetes