Joshua Schwimmer, MD, FACP, FASNTechnology in Medicine
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Thoughts on Patient-Physician Email (Part 1)

Joshua Schwimmer, MD, FACP, FASN
I'm a believer in patient-physician email communication. Let's face it -- just about every profession has enthusiastically adopted email as a rapid, non-interrupting, easily documented form of communication -- so why hasn't medicine?

There are many reasons. Here are just a few:

1. Physicians -- particularly older physicians -- may simply not use email. A recent study showed that less than half of physicians use email for medicial practice.

2. Physicians may fear providing patients easy access to them through email. Some providers I've spoken to worry that their inboxes will be filled with long, nonspecific complaints from patients rather than communications on important topics. One study even suggested that emailing patients could decrease provider income.

3. HIPAA. The Health Insurance Portability and Accountability Act requires that electronic protected health information (EPHI), including email, be communicated in a secure way -- that is, through an encrypted system. There are many commercial services available that allow encrypted patient-physician communications. For examples, of this search Google for [HIPAA and email]. In practice, however, most physicians do not have access to these encrypted email systems and are unwilling to pay for these services. In addition, patients may be unwilling to use proprietary online systems to communicate with their doctors when their everyday (unencrypted) email system is quick and simple. I've had patients complain unhappily that an encrypted online email system was too complicated to use, and why couldn't they just send me a plain old email...?

More on the many potential benefits to patient-physician email in part 2.

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2 Comments:

  • At Tue Jul 24, 02:46:00 PM 2007, Blogger Huck said…

    A limited number of patients at the two institutions where I work have requested the ability to email me. Indeed it is on my business card, so I am surprised that it isn't used more often by patients.

    The patients who do use it, 1) ask first, 2) follow the rules (e.g. don't email me when you have crushing substernal chest pain) and 3) don't email frequently.

    As a researcher, I don't get paid in a manner that I am not capturing revenue by emailing instead of telephone conversations with billing protocols, so that has never been a concern.

    I will discuss the HIPPA thing with patients now that you bring it up...

     
  • At Tue Jul 31, 08:43:00 AM 2007, Blogger The Independent Urologist said…

    I find a certain percentage of my patients like email. These patients have never "abused" email communcation and seem to share my personal views of emai. Email is a great way to communicate for doctors precisely because it is non-interrupting, nearly ubiquitous, and documentable, HIPAA concerns aside.

     

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