Hippocrates Offers Email Tips, Help for Doctors
In the November issue of Hippocrates, Laura Morasch, director of medical affairs at the California Academy of Family Physicians, offers providers suggestions and guidelines for using email to communicate with patients. Morasch notes that the "emergence of the Internet and its host of communication technologies ... could be the key to restoring [the] broken connection" between patients and doctors that has been "sabotage[d]" by "compressed" office visits. But while patients "appear eager to email their doctors," physicians "are more reluctant," according to Morasch. A 1999 Cyber Dialogue survey indicated that 48% of people interviewed wanted to email their doctors, and one-third would consider switching to physicians who do so. As for doctors, a 1999 University of Michigan study found that while 83% of physicians thought using email to answer nonurgent medical questions was a good idea, only 27% did so. Similarly, a 2000 CAFP "informal" member survey found that only 28% of physicians communicated with patients via email, and of those physicians who did not use email, 50% had no plans to offer the service. Morasch offers physicians some suggestions for using email with patients, including:
- poll patients on their interest in using email;
- establish systems for receipt, triage and response;
- consider email security systems such as encryption service Pretty Good Privacy or "secure server messaging" service Healinx;
- determine whether to use email for administrative or clinical communication;
- establish what actions are permissible over email, such as refilling prescriptions, scheduling and confirming appointments and releasing test results;
- avoid using email for time-sensitive issues or sensitive and highly confidential subjects;
- determine and inform patients of a turnaround time for answering emails;
- configure email software to automatically reply to patients to let them know email has been received;
- print out and keep each patient's email transaction;
- include as a "footnote" or "signature file" contact information or a line telling patients to call or come in for an office visit if they feel email is insufficient;
- maintain a list of patients who communicate via email; and
- review all email policies with patients, including privacy concerns, and document that conversation for the record or have the patient sign a contract
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