The trouble with email

Mary Stevens, Editor

The use of anytime-anywhere communication tools is growing by leaps and bounds. However, when it comes to communication with patients, physicians appear to be a couple of steps behind, according to a report released earlier this week. Only 6.7 percent of office-based physicians routinely emailed patients in 2008, according to the study, which was conducted by the Center for Studying Health System Change (HSC).

In contrast, twice as many physicians reported that they email other providers, and they reportedly spent at least some time each workday emailing physicians and other clinicians compared with emailing patients and their families, the study reported.

Although the HSC survey reported on data that’s roughly two years old, more recent surveys indicated physicians’ adoption of email for communicating with patients still lags behind its use in other industries. These same studies document patients’ willingness–even preference—to communicate with doctors via email about their care, and with pediatricians about the care of their children.

In its online Guidelines for Electronic Physician-Patient Communications, the American Medical Association acknowledges that “e-mail can be a valid, simple, convenient, and inexpensive mechanism for communication. It can aid the healthcare delivery process by allowing written follow-up instructions, test results and dissemination of educational materials for patients, as well as [be] a means for patients to easily reach their physician on routine health matters.”

“At the same time, issues of privacy, confidentiality and security must be addressed to ensure the efficacy and effectiveness of email,” the guidelienes stated.

Patients may be willing to discuss clinical information via email, but doctors weighing in on this topic have some concerns, including whether email interaction is reimbursable. HIPAA requires secure (i.e., encrypted) electronic transmission of protected health information, as well as its safe storage. Liability concerns may be keeping some physicians away from email; a sharpened regulatory and consumer focus on data breaches only adds to the wariness. Others worry about additional demands on their already scarce time with patients.

EHR certification initiatives and meaningful use rules are working to build security into electronic health information exchange, and both healthcare prganzations and payors are working on compensation for online patient interactions, but work remains to be done. Until these issues can be addressed, some physicians will remain offline as long as possible.

Do physicians in your organization use email to communicate with patients? What information is exchanged? Email me at mstevens@trimedmedia.com.

Mary Stevens,
Editor of CMIO