I have posted a previous note about the use of email in physician practices (link here). Here is the link to a recent article about the topic and below is an excerpt from the it:
E-mail is arguably the most common form of communication in the Information Age, but don't count on getting one from your doctor. Despite growing use of computer technology in almost every other facet of their profession, American doctors are reluctant to use e-mail when interacting with patients.... Barely one-quarter of physicians use e-mail or other electronic communication to reach patients, up from 20 percent four years ago....By comparison, more than half of doctors now use computers to store and access patient notes, up from 37 percent four years ago....In their offices, doctors are under constant pressure to curtail time spent with patients....The last thing most of them want is to give patients another way to get a hold of them....Health plans say they are not averse to paying doctors for electronic consultations, but they would like a more structured setting, such as a secured Web site that screens patients for symptoms and differentiates actual clinical consulting from administrative questions, such as checking whether lab results are in.
This article makes a number of key points and I want to comment on some of them:
- There are multiple barriers to the increased use of email by physicians to communicate with patients such as lack of reimbursement, lack of time, reluctance to adopt new technologies, and concern about a miscommunication with patients in this litigious environment.
- I think that the suggestion above about the need for a more "structured setting" for email and also to differentiate administrative matters from clinical consulting rings true. This may account for the higher adoption rate among physicians for the use of office EMRs (i.e., patient notes) when compared to the use of email.
- Many physicians manage patient email traffic on their own but would never consider answering the telephone in their office, perhaps out of concern for patient privacy. Emails should be handled in the same way as all other communication with the office.
- I think that the key to higher adoption rates for physician office email is to make the process more formal and also integrated into the office EMR systems. Office assistants and nurses need to triage all such communications, handling what they can independently and passing only the more complex clinical questions to the physician.
- This more formal documentation process and audit trail for incoming emails should satisfy health plans enough that physicians can then be compensated for the time spent answering clinical questions electronically.
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