Secure messaging (SM), asynchronous communication between patients and clinicians, is an increasingly popular tool among patients to contact clinicians about their care. Despite patients’ enthusiasm, clinicians have been hesitant to embrace the technology to communicate with patients. Using the theoretical and methodological framework of Grounded Practical Theory (GPT), we analyzed and interpreted clinicians’ perceptions, attitudes, and approaches toward SM to communicate with patients. Twenty clinicians in medical oncology and radiation oncology participated in audio-recorded, semi-structured interviews. Findings revealed the problems with using SM, such as difficulty interpreting low-quality messages, the amount of time needed to devote to responding, and its potential to negatively affect the patient-clinician relationship. Techniques employed to manage such problems consisted of using different forms of communication and utilizing messaging to expedite workloads. The philosophical rationale of clinicians toward SM was that it can improve patient care and this form of communication is already embedded within existing patient care. Overall, this article clarifies how clinicians can re-conceptualize how they think about SM so that it becomes a productive, informative, and useful aspect of patient care.

安全消息传递 (SM) 是患者和临床医生之间的异步通信，是患者与临床医生联系以了解他们的护理的一种越来越流行的工具。尽管患者热情高涨，但临床医生一直不愿采用该技术与患者交流。使用扎根实践理论 (GPT) 的理论和方法框架，我们分析和解释了临床医生对 SM 与患者交流的看法、态度和方法。20 名医学肿瘤学和放射肿瘤学临床医生参加了录音、半结构化访谈。调查结果揭示了使用 SM 的问题，例如难以解释低质量的信息、投入响应所需的时间，以及它可能对医患关系产生负面影响。用于管理此类问题的技术包括使用不同形式的通信和利用消息传递来加快工作量。临床医生对 SM 的哲学原理是它可以改善患者护理，并且这种交流形式已经嵌入到现有的患者护理中。总体而言，本文阐明了临床医生如何重新概念化他们对 SM 的看法，使其成为患者护理的一个富有成效、信息丰富和有用的方面。