JMIR Publications

ABSTRACT

Background:

Asynchronous communication via electronic modes (e-communication), including patient portals, secure messaging services, text messaging, and e-mail, is increasingly used to supplement synchronous face-to-face medical visits; however, little is known about its quality in pediatric settings.

Objective:

To summarize contemporary literature on pediatric caregivers’ experiences with and perspectives of e-communication with their child’s healthcare team to identify how e-communication has been optimized to improve patient care.

Methods:

A scoping review following Arksey and O-Malley’s methodological framework searched PubMed, CINAHL, Embase, and Web of Science using terms such as “Electronic Health Records” and “Communication” spanning 2013-2023 that discussed caregiver experiences and perspectives of e-communication with their child’s healthcare provider. Studies were excluded if they were abstracts, non-English, non-scientific papers, systematic reviews, quality improvement initiatives, and pertained to synchronous telemedicine. We conducted a two-step screening process involving title and abstract scans and full-text reviews by two independent screeners to confirm eligibility. From an initial 903 articles identified via database search, 23 articles fulfilled all inclusion criteria and are included in this review.

Results:

Of the 23 articles meeting inclusion criteria, 11 used quantitative methods, 7 used qualitative methods, and 5 used mixed methods. Caregiver sample sizes ranged from 51 to 3339 in quantitative studies and 8 to 36 in qualitative and mixed-method studies. A majority (n=17) used the patient portal as self-categorized by the study. Secure messaging through a portal or other mobile health application was used in 26% of the studies (n=6), while non-secure messaging outside of the portal was used 17% of the time (n=4) and e-mail was used one-third (n=8) of the time. In 19 of the studies, parents reported positive experiences with and a desire for e-communication methods.

Conclusions:

The literature overwhelmingly supported caregiver satisfaction with and desire for e-communication in healthcare, but no literature intentionally studied how to improve the quality of e-communication, which is a critical gap to address.