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An Exploratory Study of Physician/Patient Electronic Messaging within Secured Health Portals

Wieczorek, Susan/M (2016) An Exploratory Study of Physician/Patient Electronic Messaging within Secured Health Portals. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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When the HITECH Act of 2009 set mandates for the transition from paper to electronic health records (EHRs), few realized the far-reaching impact this technological change would have on the entire healthcare environment. This dissertation examines the many facets of this adoption process by exploring perceptions, responses, and reactions of physicians and patients alike as they navigate through this transformative “medicological environment.” Characterized by influences from legal, political, governmental, medical, social, geographical, economic, and technological factors, this multi-faceted space reveals how a new medium for communication—the electronic message within secured health portals—transforms the way in which healthcare is managed and utilized today.

Multiple methods of observation, including oral histories, surveys, critical incident reports, and content analyses of data mined messages, together reveal the many challenges faced by patients and healthcare professionals alike as they attempt to adapt to this change while still maintaining (or improving upon) primary healthcare needs. As demonstrated by the varied responses from those living in rural and urban areas, it was found that each population approached the transition process from different vantage points. The early-adopting, urban physicians provided patient online communication simply because they felt patients expected it while rural physicians tended to resist the process, arguing that patients were media illiterate, lacked Internet access, and preferred face-to-face interactions. Others cited implementation costs and personnel training issues as a deterring factor. This provides insight into how such a new medium can affect user perceptions about online healthcare, including physician availability, online relationship factors, and overall patient care. Future research suggestions include expanded content analyses of the electronic messages themselves and follow-up, longitudinal research once implementation is more widespread.

As the Institute of Medicine (2008) states, all patients have the right to varied means of communicating with their physicians, including but not limited to online interactions. Evidence of a paradigmatic shift exists in physician training as well as patient expectations. The influence of online communication within secured health portals certainly has contributed towards this shift as more personalized, patient-centered care becomes a vital part of this ever-changing medicological environment.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Wieczorek, Susan/Msusanw@pitt.eduSUSANW
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMalin, Brenton/Jbmalin@pitt.eduBMALIN
Committee MemberFischer, Gary/Sgaf1@pitt.eduGAF1
Committee MemberLyne, John/Rjlyne@pitt.eduJLYNE
Committee MemberZboray, Ronald/Jzboray@pitt.eduZBORAY
Date: 22 January 2016
Date Type: Publication
Defense Date: 21 September 2015
Approval Date: 22 January 2016
Submission Date: 4 December 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 693
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Communication: Rhetoric and Communication
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Electronic Medical Records, Electronic Health Records, Secured Health Portals, Electronic Portals, Physician/Patient Communication, Physician Relationships, email, e-mail, electronic messaging, meaningful use, data mining, lexical analysis, physician surveys, patient surveys, medicological environment
Date Deposited: 22 Jan 2016 18:23
Last Modified: 15 Nov 2016 14:31


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