Table 3.

Exemplar quotes of perceived benefits of using Secure Messaging.

Theme	Exemplar quotes
Resource efficiency	It’s [Secure Messaging] immediate and hands-on—you don’t have to wait 6 months for an appointment, you don’t have to go through acute care, you don’t have to go through all this stuff just to get a referral to your primary [care physician]…so it’s contacting the primary immediately, which is great…I think it saves money, ‘cause every time you go to acute care that costs money. So I think it saves money and a lot of time, a lot of wasted time, you know.
	That direct communication without having to stop what I was doing to go see [my primary] and try to make an appointment or get in. I can talk bluntly [on Secure Messaging] you know, just like we were face-to-face. I love that, because there were some really personal things going on, you know, with me and my body and I was like, give me some advice on this, and she would just email right away…
Communication efficiency	I like to do most of my studying at night and if I happen to think that I got to re-order this prescription, I just get on [Secure Messaging] and do it. It’s 24/7 you know, and the next thing I know I got it [prescription] within a week…It doesn’t tie up personnel at the VA. It just makes life easier.
	In Secure Messaging, you can narrate [your message] very, very precisely and have it understood by the clinical team that reads your message and it’s a lot better than someone just answering the telephone and then try to decide how your call should be routed.