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Physicians’ Use of Email With Patients: Factors Influencing Electronic Communication and Adherence to Best Practices

Posted Oct 30 2008 3:22pm

A study in the Journal of Medical Internet Research on Physician's us of e-mail with patients and adherence to best practices has elicited some interesting results. As referenced in the article, "With the public’s increased use of the Internet, the use of email as a means of communication between patients and physicians will likely increase. Yet, despite evidence of increased interest by patients, email use by physicians for clinical care has been slow.

"The objective of the study was to examine the factors associated with physician-patient email, and report on the physicians’ adherence to recognized guidelines for email communication.

One of the most important findings of the current study is that few physicians were routinely utilizing these guidelines for email communication with patients, despite their broad availability for several years. In this regard, the current study results are similar to those of Gaster and colleagues from a 2000-2001 survey of physician practices related to email use. They found that 75% of physician-respondents never or rarely obtained consent to communicate with patients by email, 66% never or rarely discussed confidentiality or security concerns and 58% never or rarely documented email in the patient record. Importantly, a separate study by White et al found that the majority of patients involved with regular physician email communication do follow guidelines when they are educated about their nature and importance. The findings by White et al, done from the patient’s perspective, coupled with the physician-oriented findings from our current study, suggest to us that the main barriers to guideline use may be more with the physician’s initiation than with the patient’s compliance.

The low rate of adherence to published physician-patient email guidelines may have several reasons. Among these reasons may be the lack of knowledge about the existence of guidelines by many practicing physicians; the lack of agreement with the guidelines (eg, not feeling that the guidelines are required in their particular practice), or an impracticality to their implementation. Unfortunately, the present study was not designed to determine reasons for not adhering to these recommended guidelines. However, given the results presented in the current study, the medical profession should consider further educating physicians about email communication, assess the barriers facing implementation, and better understand the practicality of utilizing the guidelines themselves. To read the full article, click here: Journal of Medical Internet Research - Physicians’ Use of Email With Patients: Factors Influencing Electronic Communication and Adherence to Best Practices."

E-mail communication between physicians and patients is here to stay. How do we move the goal posts closer to best practices in a setting in which providers of care are overwhelmed with the current state of information overload? This article feeds into the previous posting - Is Compensated Online Care Just Around the Corner?

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