September 3, 2004 09:20 PM
E-mail as a way of communicating with patients ?
I just read a very interesting paper published at the Journal of General Internal Medicine.
Katz, Steven J. & Moyer, Cheryl A. (2004)
The Emerging Role of Online Communication Between Patients and Their Providers.
Journal of General Internal Medicine 19 (9), 978-983.
doi: 10.1111/
j.1525-1497.2004.30432.x
Abstract
We have discussed this issue in another post. Things are evolving fast, and indeed with all the privacy concerns and problems associated with e-mail, this article points that the best way would be to create "patient portals".
Here is an excerpt from the article above:
E-mail presents an attractive alternative to more traditional modes of communication for several reasons. It is now used in virtually all employment settings and many patients use it on a daily basis. Furthermore, e-mail systems are now highly compatible across platforms, resulting in seamless communication between operating systems. Its enormous reach and asynchronous nature are especially attractive to patients and providers whose busy schedules make it difficult to connect over the phone. However, a number of significant problems with e-mail limit its use in clinical settings. First, e-mail presents several security-related challenges. The author of an incoming e-mail cannot be easily verified. Furthermore, because e-mail is generally not encrypted, messages accidentally or intentionally forwarded, copied, or intercepted can be read by third parties, and is thus not in compliance with current Health Insurance Portability and Accountability Act of 1996 regulations. 25 Second, e-mail is an unstructured, free-text medium, which may yield ambiguous or incomplete messages from patients. While patients may see this unstructured environment as an asset of e-mail, providers faced with responding to an incomplete message are likely to disagree. Third, there is no uniform way of tracking incoming and outgoing e-mail messages and whether a sent message is ever opened. Finally, it is difficult to efficiently integrate e-mail into clinic operations because messages cannot be automatically routed to the appropriate staff person and exchanges cannot be efficiently documented in the medical record.
I think that not using e-mail is very reasonable, for the reasons above. In the article, the authors suggest the creation of "patient portals", which may be a good alternative for larger institutions, but projects like that not only cost a fortune, but also take time to create and have to be customized for each client.
For the time being, I have discarded all communication via e-mail with patients. If asked, I politely ask them to go through the standard routes to get to me. I am interested to see how this develops.
Posted by leo at September 3, 2004 09:20 PM
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