JMIR Publications

ABSTRACT

Background:

Patients’ online access to their medical records and secure messaging (SM) via patient portals are becoming increasingly prevalent on an international scale. SM offers a number of potential benefits, including enhanced health outcomes and improved patient engagement. However, it also raises concerns about effects on the therapeutic relationship and may be constrained by factors such as limited digital literacy and access to digital devices. Evidence on the use of SM in mental health is limited and results are inconclusive.

Objective:

The present study examines the purpose and usage patterns of the SM function in patient portals used by patients affected by a severe mental health condition and healthcare professionals (HCPs).

Methods:

SMs (n=310) of 38 patients and 4 HCPs from 3 psychiatric outpatient clinics in Brandenburg were analyzed using thematic analysis.

Results:

Four core functions of SM were identified: (1) reporting/feedback, (2) interpersonal, (3) intrapersonal, and (4) organizational functions. Through the reporting and feedback function, SM could convey treatment-relevant information and elicited feedback on treatment and medication. Interpersonal aspects in SM included expressions of gratitude, well wishes, and emotional support, whereas intrapersonal SM components allowed patients to reflect on their treatment and provide self-encouragement. Organizational aspects addressed scheduling, appointments, and administrative tasks.

Conclusions:

SM in psychiatric outpatient care is multifaceted and can potentially enhance therapeutic relationships and accessibility of care, but it requires training, guidelines, and workflow adjustments. Further research is needed to address the ethical, privacy, and practical implications for effective implementation. Clinical Trial: The study has been registered with the German Clinical Trials Registry (No. DRKS00030188).