Electronic Communication Improves Access, But Barriers To Its Widespread Adoption Remain

Abstract

Principles of patient-centered care imply that physicians should use electronic communication with patients more extensively, including as a substitute for office visits when clinically appropriate. We interviewed leaders of 21 medical groups that use electronic communication with patients extensively and also interviewed staff in six of these groups. Electronic communication was widely perceived to be a safe, effective and efficient means of communication that improves patient satisfaction and saves patients time, but increases the volume of physician work unless office visits are reduced. Practice redesign and new payment methods are likely necessary for electronic communication to be used more extensively.

Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice

“…There were also a few positive accounts of experiences and an acknowledgement of when, how, and for whom these alternatives may be beneficial, reflecting previously reported findings. 11,20,33 Implications for research and practice Due to the limited use of email or internet video within the responder group, in keeping with previous literature, the concerns listed are based primarily on perception and anecdote. 21 This general reluctance to adopt alternatives to face-to-face consultations is therefore unlikely to change without a change in policy.…”

Family Caregivers and Consumer Health Information Technology

“…42 Identified advantages of asynchronous communication include convenience, efficiency, and electronic documentation of interactions. 43,44 Greater involvement of family caregivers in secure messaging, as desired by patients, could enhance coordination of care and increase the likelihood of including the appropriate persons (including both patients as well as multiple family members) in important medical decisions. Affording family members or close friends who live at a distance and cannot be physically present at the bedside with more timely and accurate information would enable them to better understand treatment decisions and engage in family discussions about care or participate in remote family conferences.…”

Postoperative care using a secure online patient portal: changing the (inter) face of general surgery

“…30 As technology improves and smartphone use becomes ubiquitous, patients are now seeking remote care for other reasons, including 24/7 access and convenience. [15][16][17][18] This is evidenced by widespread adoption of online patient portals. 9,10,31 In light of these changes in how healthcare is delivered, some surgeons have begun to re-consider the essential elements of perioperative care and to re-define how care is delivered.…”

“…8,[10][11][12][13][14] An added benefit of online portals is asynchronous communication between patients and care teams, enabling patients and providers to address health care needs at times and locations that are convenient for them. [15][16][17][18] Patients and providers are also realizing the benefits of sharing digital images asynchronously using electronic transmission. Classically known as "store-and-forward" telemedicine, this approach has been used successfully to provide clinical assessments and follow-up care in dermatology, plastic surgery, and burn care.…”

“…Travel distance, miles, median (range) 24 Education, n (%) High School 11 (22) Associate's degree 9 (18) Bachelor's degree 14 (28) Masters/doctoral degree 16 (32) Employment, n (%) …”