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Most modern businesses have long-since exploited the many uses for e-mail, both within their organizations and to communicate with customers and outside vendors. Medical offices, however, must consider several issues before establishing a policy regarding the use of e-mail to communicate with patients.

There are obvious advantages tied to the use of e-mail. It offers all the advantages of the written word, for example, the ability to document the content of communications from both sides, creating a history of the dates and times the communication took place and the opportunity to more carefully choose your words than you would in conversation. At the same time, depending on how quickly the correspondents respond to each other, it can be nearly as spontaneous as a conversation, allowing for debate or other give-and-take aspects associated with verbal communication.

Many of these advantages obviously apply to medical offices. The idea of dashing off an e-mail with

prepared instructions attached for a patient seems attractive and efficient. A busy doctor may not have time to take a phone call at a particular time, but can send an e-mail when the chance presents itself. Many language barriers can be bridged between patients and healthcare providors since e-mails do not have accents and can be read at whatever pace the recipient is comfortable with. Replys can be solicited and received in short order. If the doctor, or the patient, forgets to ask a question, they can follow up quickly. Geographical barriers become irrelevant, a particularly useful quality should the doctor or patient be out of town. Office hours can be extended with less of a burden on the doctor or staff, since they can retrieve and respond to e-mail from their home or a remote location. Patients can get a message through without jamming up, or putting up with, an automated voice mail or screening system.

Issues to resolve

                                      

Practices that wish to take advantage of all these possibilities, however, must proceed with caution. There are a number of issues to resolve, over and above the reality that some patients do not have access to e-mail or find it to be a difficult or impersonal method of contact. Legal and ethical concerns are other important matters that must be addressed.

Not surprisingly, this is a hot topic in some medical circles. The Journal of the American Medical Informatics Association (AMIA), in fact, published a widely read white paper in 1998 that addressed these concerns and published guidelines for the clinical use of electronic mail with patients.

These guidelines were listed in a previous article published on this web site: To Use E-Mail or Not? But with more and more individuals and businesses becoming more and more comfortable with–and reliant on–the regular use of e-mail, how have perceptions changed in recent years?

Dr. George Lundberg, former editor of the Journal of the American Medical Association, was once quoted as saying the Internet is “the most important advance in medical communications since the printing press” and e-mail “is its most useful tool.” But as we learn more about the pros and cons of e-mail, it would seem that the medical profession is choosing to sacrifice the advantages of e-mail in the interest of medical ethics, at least until the nature of e-mail, or at least the current concerns about privacy, are changed.

Possible solutions

                                       

There are steps being taken to address the need for medical practices to harness the power of the Internet without compromising privacy and security. One of the services provided by some practices is a secure “Patient Center” service, whereby patients can communicate with member medical offices, protected by the safety of a password-protected access. It allows patients to create a personal health profile they can edit or update at their convenience as well as make appointments, request prescriptions and inquire about billing online. They can also access a medical encyclopedia and other health information 24 hours a day. It is interesting to note that a survey indicating that 48 percent of patients want the ability to communicate with physicians online.

If you have any questions, don’t hesitate to e-mail us at:  tom@hartwig.com