Why Patient Portal Messages Indicate Risk of Readmission for Patients with Ischemic Heart Disease

Overview

Journal AMIA Annu Symp Proc

Specialty Medical Informatics

Date 2020 Apr 21

PMID 32308879

Citations 5

Authors

Lina Sulieman

Zhijun Yin

Bradley A Malin

Affiliations

Soon will be listed here.

Abstract

Online portals enable patients to exchanging messages with healthcare providers. After discharge, patients message providers to ask questions and report problems. Care providers read and respond accordingly, which requires a non trivial amount of human effort and is unlikely to scale up as portals become more popular. Automatically detecting when a message indicates a worsening in a patient's condition can assist providers to identify patients at risk of readmission. We investigated the association between messages that patients, diagnosed with ischemic heart disease, sent after discharge and the risk of readmission. We studied 4,052 messages sent after discharge for 1,552 patients. We represented messages using inferred latent topics, linguistic features (e.g. emotions, activities), and clusters of medical terms. Our analysis indicates that mentioning medication dosage and additional procedures are associated with readmission. Moreover, patients who were readmitted rarely mentioned leisurely activities or described their insights about their health information.

Citing Articles

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Optimizing Word Embeddings for Patient Portal Message Datasets with a Small Number of Samples.

Song Q, Ni C, Warner J, Chen Q, Song L, Rosenbloom S Res Sq. 2024; .

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Remote Communications between Patients and General Practitioners: Do Patients Choose the Most Effective Communication Routes?.

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Identifying Medication-Related Intents From a Bidirectional Text Messaging Platform for Hypertension Management Using an Unsupervised Learning Approach: Retrospective Observational Pilot Study.

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Quantifying Patient Portal Use: Systematic Review of Utilization Metrics.

Beal L, Kolman J, Jones S, Khleif A, Menser T J Med Internet Res. 2021; 23(2):e23493.

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References

Soysal E, Wang J, Jiang M, Wu Y, Pakhomov S, Liu H . CLAMP - a toolkit for efficiently building customized clinical natural language processing pipelines. J Am Med Inform Assoc. 2017; 25(3):331-336. PMC: 7378877. DOI: 10.1093/jamia/ocx132. View

Yin Z, Harrell M, Warner J, Chen Q, Fabbri D, Malin B . The therapy is making me sick: how online portal communications between breast cancer patients and physicians indicate medication discontinuation. J Am Med Inform Assoc. 2018; 25(11):1444-1451. PMC: 7646923. DOI: 10.1093/jamia/ocy118. View

Sulieman L, Gilmore D, French C, Cronin R, Jackson G, Russell M . Classifying patient portal messages using Convolutional Neural Networks. J Biomed Inform. 2017; 74:59-70. DOI: 10.1016/j.jbi.2017.08.014. View

Sulieman L, Fabbri D, Wang F, Hu J, Malin B . Predicting Negative Events: Using Post-discharge Data to Detect High-Risk Patients. AMIA Annu Symp Proc. 2017; 2016:1169-1178. PMC: 5333334. View

Weingart S, Hamrick H, Tutkus S, Carbo A, Sands D, Tess A . Medication safety messages for patients via the web portal: the MedCheck intervention. Int J Med Inform. 2007; 77(3):161-8. DOI: 10.1016/j.ijmedinf.2007.04.007. View

Haun J, Lind J, Shimada S, Martin T, Gosline R, Antinori N . Evaluating user experiences of the secure messaging tool on the Veterans Affairs' patient portal system. J Med Internet Res. 2014; 16(3):e75. PMC: 3961805. DOI: 10.2196/jmir.2976. View

Yin Z, Chen Y, Fabbri D, Sun J, Malin B . #PrayForDad: Learning the Semantics Behind Why Social Media Users Disclose Health Information. Proc Int AAAI Conf Weblogs Soc Media. 2019; 2016:456-465. PMC: 6708414. View

Otte-Trojel T, de Bont A, van de Klundert J, Rundall T . Characteristics of patient portals developed in the context of health information exchanges: early policy effects of incentives in the meaningful use program in the United States. J Med Internet Res. 2014; 16(11):e258. PMC: 4260079. DOI: 10.2196/jmir.3698. View

Kruse C, Bolton K, Freriks G . The effect of patient portals on quality outcomes and its implications to meaningful use: a systematic review. J Med Internet Res. 2015; 17(2):e44. PMC: 4342639. DOI: 10.2196/jmir.3171. View

10.

Shenson J, Cronin R, Davis S, Chen Q, Jackson G . Rapid growth in surgeons' use of secure messaging in a patient portal. Surg Endosc. 2015; 30(4):1432-40. PMC: 4881849. DOI: 10.1007/s00464-015-4347-y. View

11.

Osborn C, Rosenbloom S, Stenner S, Anders S, Muse S, Johnson K . MyHealthAtVanderbilt: policies and procedures governing patient portal functionality. J Am Med Inform Assoc. 2011; 18 Suppl 1:i18-23. PMC: 3241162. DOI: 10.1136/amiajnl-2011-000184. View

12.

Cronin R, Fabbri D, Denny J, Jackson G . Automated Classification of Consumer Health Information Needs in Patient Portal Messages. AMIA Annu Symp Proc. 2016; 2015:1861-70. PMC: 4765690. View

13.

Zhou Y, Kanter M, Wang J, Garrido T . Improved quality at Kaiser Permanente through e-mail between physicians and patients. Health Aff (Millwood). 2010; 29(7):1370-5. DOI: 10.1377/hlthaff.2010.0048. View

14.

Nazi K, Woods S, Woods S . MyHealtheVet PHR: a description of users and patient portal use. AMIA Annu Symp Proc. 2008; :1182. View

15.

Cronin R, Fabbri D, Denny J, Rosenbloom S, Jackson G . A comparison of rule-based and machine learning approaches for classifying patient portal messages. Int J Med Inform. 2017; 105:110-120. PMC: 5546247. DOI: 10.1016/j.ijmedinf.2017.06.004. View

16.

North F, Crane S, Stroebel R, Cha S, Edell E, Tulledge-Scheitel S . Patient-generated secure messages and eVisits on a patient portal: are patients at risk?. J Am Med Inform Assoc. 2013; 20(6):1143-9. PMC: 3822104. DOI: 10.1136/amiajnl-2012-001208. View

17.

North F, Crane S, Chaudhry R, Ebbert J, Ytterberg K, Tulledge-Scheitel S . Impact of patient portal secure messages and electronic visits on adult primary care office visits. Telemed J E Health. 2013; 20(3):192-8. PMC: 3934543. DOI: 10.1089/tmj.2013.0097. View

18.

Houston T, Sands D, Jenckes M, Ford D . Experiences of patients who were early adopters of electronic communication with their physician: satisfaction, benefits, and concerns. Am J Manag Care. 2004; 10(9):601-8. View

19.

Wade-Vuturo A, Mayberry L, Osborn C . Secure messaging and diabetes management: experiences and perspectives of patient portal users. J Am Med Inform Assoc. 2012; 20(3):519-25. PMC: 3628058. DOI: 10.1136/amiajnl-2012-001253. View