Table 1.
Primary topic categories
| Category | Description | Example |
|---|---|---|
| Medical advice | Physical or mental health problem or concern not coded as a medication issue or test issue | “My right shoulder has been extremely sore for more than a month. I can’t lift my right arm up and to the side without great pain. This has been over a month and is getting worse.” |
| New or change in medication request | Request for a new medication or a change of current medication | “My current medication isn’t working for me anymore but my sister-in-law recommended [medication name]. Can you prescribe me that?” |
| Medication renewal or refill | Request for refill or renewal of a medication or medical supply | “Please renew my prescription to oxycodone HCL 5 mg tab. Please have pharmacy mail [it] to me.” |
| Medication issue/question | Medication or supply issue that is not a refill/renew request or a problem with receiving the medication in mail (eg, questions about dose or side effects) | “I’m sending a list of vitamins and supplements I take. Please have the doctor make sure they are okay to take and don’t counteract what I take for my Parkinson’s [disease].” |
| Imaging request | Request for imaging/test | “I’ve been having terrible headaches and I want a CT scan to see what the problem is.” |
| Imaging issue/question | Patient questions about imaging, choosing among imaging options, why a particular imaging procedure is important, preparing for a scan/imaging procedure | “Am I allowed to eat before my MRI tomorrow?” |
| Imaging result | Request for or discussion of imaging results | “Hello, I got the ultrasound [scan result] last week and I want to know what are the next steps to take?” |
| Lab/test request | Request for lab test | “I need some bloodwork done.” |
| Lab/test issue/question | Patient questions about testing, choosing among testing options, why a test is important, preparing for a test | “Did you want me to get lab work done before I see you?” |
| Lab/test results | Request for or discussion of test results | “Thanks for sending me the test results. I still have a question for the doctor about the numbers that you gave me.” |
| Surgery or procedure issue/question | Patient questions about a surgery or procedure | “Good morning. I am still having a lot a lot of pain in my knees. The injections did not seem to help. But I heard the second time around it usually helps a lot more. So, I was wondering if I can get another injection in my knees??” |
| FYI informing | Patient sharing information with no additional discussion that does not fit other category (eg, inform about non-VA care or test result) | “Just to keep you posted. EKG done yesterday. Bloodwork and urine done this AM.” |
| Scheduling | Schedule an appointment, test, or procedure | “I would like to set up an appointment for a physical.” |
| Referral | Request referral to a specialist | “I would like to be referred to MOVE! to help me with some weight loss. I also need you to set up an appointment for [examination of] my knees and lower back. I’m having a great deal of pain in both, been injured in the past. Thank you.” |
| Note request | Request doctor’s note | “I’m supposed to go on vacation this week but I’m too sick to fly. Can you write me a note for my travel insurance?” |
| Administrative | Administrative issues other than appointment scheduling | “I didn’t receive my medication in the mail.” |
| Life issue | Any contextual issues that are not strictly biomedical and are about the patient’s life context | “We’re having lots of changes with my mom. Hospice people are coming here but now they’re talking about putting her in a nursing home. They say they can help her all the time.” |
| Callback request | Simple callback request | “Please call me at xxx-xxx-xxxx when you get the chance.” |
| Thanks | Expressing appreciation | “I do want to take a minute to thank you for your help. It is a different world going through a pain-free day. You have been kind and caring and I do really appreciate it!!!” |
| Complaint | Complaining about care, services, KP, etc | “First and foremost … and I would think you would be aware of this by now, [patient first name] is NOT my Dad … he’s my husband.” |
| Other | Content not captured by the above categories | “Both of my glucose] meters are reading E-9 when trying to get a reading. I think it’s the battery, but I don’t know how to fix it. Tell me how or what to do.” |
AM = morning; CT = computed tomography; EKG = electrocardiogram (ECG); FYI = for your information; HCL = hydrochloride; KP = Kaiser Permanente; lab = laboratory; MOVE! = Veterans Affair’s National Weight Management Program; MRI = magnetic resonance imaging; tab = tablet; VA = Veterans Affairs.