TY - JOUR
T1 - Automated strategy feedback can improve the readability of physicians’ electronic communications to simulated patients
AU - Roscoe, Rod D.
AU - Balyan, Renu
AU - McNamara, Danielle S.
AU - Banawan, Michelle
AU - Schillinger, Dean
N1 - Funding Information:
This work was supported by grants from the National Institutes of Health ( NIH/NLM R01LM012355 and NIH 2P30DK092924–11 ), UCSF Marcus Precision Medicine Award, Department of Education Institute of Education Sciences ( IES R305A180261 ), and Department of Defense Office of Naval Research ( ONR N00014–20–1–2623 ). The opinions and findings expressed in this work do not necessarily reflect the views of the funding institutions. Funding agencies had no involvement in the conduct of any aspect of the research.
Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/8
Y1 - 2023/8
N2 - Modern communication between health care professionals and patients increasingly relies upon secure messages (SMs) exchanged through an electronic patient portal. Despite the convenience of secure messaging, challenges include gaps between physician and patient expertise along with the asynchronous nature of such communication. Importantly, less readable SMs from physicians (e.g., too complicated) may result in patient confusion, non-adherence, and ultimately poorer health outcomes. The current simulation trial synthesizes work on patient-physician electronic communication, message readability assessments, and feedback to explore the potential for automated strategy feedback to improve the readability of physicians’ SMs to patients. Within a simulated secure messaging portal featuring multiple simulated patient scenarios, computational algorithms assessed the complexity of SMs written by 67 participating physicians to patients. The messaging portal provided strategy feedback for how physician responses might be improved (e.g., adding details and information to reduce complexity). Analyses of changes in SM complexity revealed that automated strategy feedback indeed helped physicians compose and refine more readable messages. Although the effects for any individual SM were slight, the cumulative effects within and across patient scenarios showed trends of decreasing complexity. Physicians appeared to learn how to craft more readable SMs via interactions with the feedback system. Implications for secure messaging systems and physician training are discussed, along with considerations for further investigation of broader physician populations and effects on patient experience.
AB - Modern communication between health care professionals and patients increasingly relies upon secure messages (SMs) exchanged through an electronic patient portal. Despite the convenience of secure messaging, challenges include gaps between physician and patient expertise along with the asynchronous nature of such communication. Importantly, less readable SMs from physicians (e.g., too complicated) may result in patient confusion, non-adherence, and ultimately poorer health outcomes. The current simulation trial synthesizes work on patient-physician electronic communication, message readability assessments, and feedback to explore the potential for automated strategy feedback to improve the readability of physicians’ SMs to patients. Within a simulated secure messaging portal featuring multiple simulated patient scenarios, computational algorithms assessed the complexity of SMs written by 67 participating physicians to patients. The messaging portal provided strategy feedback for how physician responses might be improved (e.g., adding details and information to reduce complexity). Analyses of changes in SM complexity revealed that automated strategy feedback indeed helped physicians compose and refine more readable messages. Although the effects for any individual SM were slight, the cumulative effects within and across patient scenarios showed trends of decreasing complexity. Physicians appeared to learn how to craft more readable SMs via interactions with the feedback system. Implications for secure messaging systems and physician training are discussed, along with considerations for further investigation of broader physician populations and effects on patient experience.
KW - Automated feedback
KW - Electronic health records
KW - Health literacy
KW - Natural language processing
KW - Patient-physician communication
KW - Readability
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U2 - 10.1016/j.ijhcs.2023.103059
DO - 10.1016/j.ijhcs.2023.103059
M3 - Article
AN - SCOPUS:85153372292
SN - 1071-5819
VL - 176
JO - International Journal of Human Computer Studies
JF - International Journal of Human Computer Studies
M1 - 103059
ER -