Table 4.

Qualitative themes and representative quotes.

Communication theme	Quote
Reliability	Cellphones don’t work real [sic] well around here, you have to be in certain areas. There’s lots of dead spots, like hundreds of miles of it…It works better for [hospital] to use secure messaging to set up appointments. I’ve used them to talk to [the clinic], I’ve used them to talk to my provider a couple of times when I needed prescriptions changed or stuff like that. [Rural male, 69 years]
Communicate needs rapidly	I’ve got central tremors and…I’m shaking and I can’t get the syringe in the bottle you know. So I just sen[t]… a SM. I said Dr. [name] I want to get pens again I can’t do it. Within 48 hours, I’m serious, literally. I had pens delivered to my front door you know. Just absolutely wonderful as far as I’m concerned. [Rural male, 54 years]
Facilitates communication with team	Once I tried to message them or if I sent a message to the nursing staff then the next time I got on there, there was a connection for me to, you know, to send a message directly to my pharmacist... [Rural female, 65 years]