Thursday, June 20, 2013

What The Experts Say About Communicating with Patients by Email
You've got mail.
Title of 1998 Film, Sleepless in Seattle

Email has changed the worlds of personal communication.

Email has:

·         Placed the U.S. Postal Service in deep debt because people no longer use personal letters to communicate.

·         Replaced handwritten notes to invite others to weddings, funerals, bar mitzahs, showers, birthday parties and other social events.

·         Rendered “thank you” notes passé.
But one group – physicians – has held out. Doctors hesitate to communicate with patients by email. The reasons are legend.

·         Emails carry significant  medical-legal risks.

·         Third parties do not usually compensate for emails.

·         Email may replace patient visits where clinical judgments and payments occur.

·         Emails are impersonal:  you can’t judge a patient’s physical appearance,  body language,  vital signs by email, or clinical condition by email

Yet polls show patients overwhelming prefer physicians who communicate by email.  Emails, in concert with telephone calls,  have become indispensable for informing patients. Emails are convenient, fast, and save time, e.g. in fulfilling prescriptions and informing patients about lab or procedural results.

The Wall Street Journal has weighed in by asking a panel of experts this question; Should doctors communicate with their patients by email?

Here, in part, are experts’ answers:

·         Jeffrey Flier, MD, Dean of Harvard Business School.

Excellent communication between physicians and patients is a core requirement of effective medical care. Like so many aspects of medical care, there is no single approach to communicating that will meet the needs of all physicians and patients, or that will apply across all circumstances. But as email has become increasingly commonplace in our society, incorporating its use into medical practice is unavoidable. If its use is properly structured, email communication can offer significant benefits to physicians, patients and the broader health-care system.

·         George Halvorson,  CEO  of Kaiser Permanente

Yes. Absolutely. Doctors should connect with patients by email. Email is one of the best ways of connecting between doctors and patients. A secure message line that allows doctors and patients to exchange information can be extremely convenient, logistically respectful for the patient and a very flexible way for physicians to get needed information to their patients.

·         Gurpeet Dhaliwal, MD. Associate Professor of Clinical Medicine, at U. of California San Francisco

Email communication is ubiquitous, efficient and convenient. Patients want it, and many doctors do too. Every other industry maintains electronic communications with its customers, but in health care the debate inexplicably drags on.

Email is simply another form of communication like face-to-face exchanges, phone, mail or texting. Each medium has a different profile of strengths and flaws, but their financial, liability and privacy issues have many similarities—and all can be managed/.

·         Peter Provonost, MD, Professor, anesthesiologist, Johns Hopkins School of Medicine

Yes. Email provides an efficient and effective means for patients and physicians to communicate, although it is a tool that should supplement, not supplant, face-to-face interactions. Renewing prescriptions, scheduling a visit, ordering and following up on tests and communicating non-worrisome test results can all be handled via email. This can be a time-saver for the patient and physician, allowing in-person visits to be dedicated to working towards that individual’s health goals.

·         J.D. Kleinke,  Medical economist, resident fellow, American Enterprise Institute

Of course, and it is bizarre that in 2013 we are still asking this question. Electronic communications pervade all elements of our lives, have radically transformed all other spheres of economic life and culture, and bring efficiencies to human interactions we could no longer imagine life without.

·         Pamela Barnes, MD, president and CEO of EngenderHealth

Communicating with patients via email has enhanced many public health interventions, including use of oral contraceptives, HIV medication and sunscreen. With growing access to smart and mobile phones globally, SMS/text messaging has also been successful, especially for sending reminders to take medication, scheduling follow-up appointments, or making payments. In some remote areas of the world, text messaging provides new opportunities to reach patients with health information, organize transport to health services, and/or contact health workers. Ultimately, no matter where one lives, e-communication is an excellent tool to supplement—not replace—a trip to the doctor.

·         Susan Devore, President and CEO of Premier Healthcare Alliance

U.S. workers spend about 30% of their office time on email, typing 42,000 words a year – that’s equivalent to a 166 page novel! Yet less than 6% of us have used email to communicate with care providers.

Email can’t–and shouldn’t–replace hands-on care delivery, especially in emergencies. But research tells us that patients and physicians find email communication to be beneficial, saving both time and money while improving satisfaction. I know for obvious, minor issues such as a common cold or inquiries about routine test results, I’d prefer virtual interaction instead of time-consuming and sometimes costly face-to-face office visits.

Tweet;  Health care experts and thought leaders overwhelmingly support physician email communication with patients as an inevitable trend.

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