Getting Results with Digital Messaging for Asthma Care

Over the last 15 years living with severe asthma and other chronic health issues that followed, I have developed some pretty strong health advocacy and communication skills with my care providers.

When electronic messaging and more text-based virtual care options entered my life in 2019, and even more-so in 2021 and beyond, I have figured out some key elements to having success in communicating with my care team (primarily my family doctor--known here as Dr. Awesomesauce--who oversees my care and keeps tabs on the notes from all my various specialists).

I have found the most important thing about successful electronic communications with my doctors is knowing when it is sensible to use, but also how best to construct messages--especially now that I have had 2 doctors tell me a non-asthma issue I am dealing with is complex!

Choosing the right time

In an article generally praising electronic methods of receiving care, it feels funny to start with this, but here it is:

Messaging does not work in all situations or scenarios.

I think a key reason I have had success using it with my doctors is I know by now what is suitable for a message, a call, or just booking an appointment, either by phone or in person. To get this out of the way: "major" things or things that are time-sensitive are always best dealt with by making a call and/or booking an in-person visit. I will share what those things are for me in a second. 

When I feel I am in a grey area, especially with my family doctor, I send the message and always say "Let me know if I should book an appointment"--so far, he has never asked me to, so I must be on the right track overall!

In-person visits, phone calls, or digital messaging: Scenarios in asthma care

While my asthma has been really well controlled for the last few years, there are some hard-and-fast rules where I know I should be seen in-person for care--this also applies to many non-asthma things.

I have to say this first: if you need anything urgently or are struggling with your asthma and do not know what to do do not send a message. This is absolutely territory where you need to at the very least make a phone call for advice!

Times I opted to go into the office

If I have symptoms or something that needs looking at--or I even somewhat suspect he will want to examine me--I go in. Two of three times I have booked in-person follow-ups for a specific issue, he has not needed to examine me, but the conversations also made sense to have face-to-face. Luckily, I have not had any major asthma issues since I started seeing him, but if I did, I would probably send a message asking if I should start prednisone or if he wanted to see me first.

Other than things that must be dealt with face-to-face, like when an exam or a little "let's listen to your lungs" may be needed, there are things I just always find simpler dealing with in-person.

Dr. Awesomesauce prescribed me a year worth of most of my asthma medications (and non-asthma meds) in September 2022. When those all start to hit 1-2 refills, I will likely go in with a paper list and get him to refill them that way.

I also went in last year when my cardiologist said I could consider medicine for my heart rate and I wanted Dr. Awesomesauce's opinion--I felt that, too, was a conversation best had face-to-face (or at least voice-to-voice).

When there are multiple layers to an issue, as well, I feel it might be good to go in--but not always, it really depends on you and your doctor, their comfort with technology, and your communication styles.

Examples where messaging was appropriate

Recently, I had a longer update on a complex non-asthma situation I sent by message to Dr. Awesomesauce, primarily to see if he had any other ideas. I felt hesitant to send it, given the length! It turned out he has not received updates from 1 of the 2 specialists involved, and thanked me for looping him in. He also told me to let him know if there was anything he could help with. He deferred continued care to my specialists, as I expected, but sometimes a primary care doctor with a wider view can present new suggestions, too, and I always welcome his input.

The best use I have found for messaging in asthma care? Prescription refills, hands down!

Structuring digital messages for the best results

Effective care via electronic message with your doctor, I think, really comes down to the type of relationship you have, and being adequately informed about the situation. Part of this is informing yourself and knowing you are the expert on you but they are the expert in medicine. Some of this, of course, applies to in-person visits, too!

Certainly, you don't have to go all-in and have spent 20+ hours in the last month reading medical journals and textbooks like I have, but being informed is something I've found is key to being able to ask the right questions! (And hey, you're already here on Asthma.net, so if you're not already there, you're off to a great start!)

Above all, keep it as brief as possible but provide enough detail to help them move forward. You can always send a follow-up or book a visit if you need to! Here's an example from when I asked Dr. Awesomesauce about checking if low B12 could be contributing to my chronic regional pain issue:

[...] We haven't looked into vitamin B12 deficiency in this quest to date; coworker just brought it up as having been helpful addressing his nerve pain and suggested asking about that! I just checked my labs from urgent care in July 2021 but they didn't do a B12 etc; do you think that is worth a shot? Thank you!"

This in turn had him confirm we should check, and run routine labs at the same time to get that done with--win-win!

Yes, sometimes a longer message (as mentioned above) is necessary--but ensure it's really necessary and time-saving for both of you.

This is, I think, how I've had good results with using messaging and email with my doctors. I try to keep my messages concise, inform myself as well as I can, include the information they may need to avoid too much back-and-forth, and offer to book a visit for in-person care in situations where that may be the better option.

I have had a great deal of successful communications with my care team this way, and I hope this is helpful for you, too!

How have your experiences been using messaging or email with your asthma care team?