Table 3

Relationship between change in clinical status and subsequent initial use of shared medical record using alternate Cox time varying proportional hazards models

Hazard ratio for SMR use in same month of changeHazard ratio for SMR use within 3 months of changeHazard ratio for SMR use within 6 months of changeHazard ratio for SMR use any time after change
Change to higher morbidity level*NA1.60 (1.28–2.01)1.38 (1.14–1.66)1.20 (1.05–1.38)
Change to PCP with higher level secure messaging use3.02 (1.66–5.51)1.56 (1.10–2.24)1.44 (1.09–1.90)1.13 (0.95–1.36)
Change to begin insulin therapy1.95 (1.15–3.30)1.67 (1.03–2.70)1.47 (1.01–2.16)1.15 (0.91–1.46)
  • Data are hazard ratios (95% CI). n = 5,500; each outcome was adjusted for all variables listed, as well as age, sex, neighborhood SES, estimated driving distance from clinic, and baseline morbidity, insulin use, and PCP level of SMR. All time periods include initial month or quarter of change.

  • *From moderate or lower morbidity to high or very high morbidity.

  • †To PCP with >10% higher average secure messaging use during study period.

  • ‡From diet control or oral therapy.