Physicians’ use of and attitudes toward electronic mail for patient communication

Abstract

To assess physicians' use of and attitudes toward electronic mail (e-mail) for patient communication, we conducted a mailin survey of physicians who see patients in outpatient clinics affiliated with a large academic medical center (N = 283). Seventy-two percent of physicians reported using e-mail to communicate with patients, averaging 7.7 e-mails from patients per month. The lowest level of use was by communitybased primary care physicians (odds ratio, 0.22; 95% confidence interval, 0.08 to 0.59). Those physicians who reported using e-mail with patients reported high satisfaction with its use. Although physicians were concerned about the confidentiality of e-mail, few discussed this issue with patients.

Telemedicine in Primary Care

“…(Moyer et al, 2002a) Physicians who are more likely to use emails with their patients were younger, university based (Gaster et al, 2003), had training in family medicine or surgery and practiced in large groups of 50 or more. (Brooks & Menachemi, 2006) Older physicians (>60 years old) and physicians of Asian descent are unlikely to involve in email usage with their patients.…”

“…Important barriers or concerns cited among physicians are lack of time and increase in workload, security and confidentiality, and reimbursement. (Gaster et al, 2003;Moyer et al, 2002b;Pizziferri et al, 2003) However, studies have not proven this fear of increase in workload. Over 6 months period, there was no increase in the volume of messages or time spent answering the messages between physicians who used telephone messages with their patients compared to those who used email communication.…”

“…(Leong et al, 2005) In university based clinics, the majority of the physicians used email communication with their patients and self-reported an average of 8 emails per month. (Gaster et al, 2003) Controlled trials have shown that physicians respond to an average of 12-13 emails per week spending 5-10 minutes a day. (Virji et al, 2006) When email users in the general population were asked about their willingness to pay for email communication with their providers, 47% reported that they will not be willing to pay for email communications and 38% were ready to play 5-10 dollars.…”

“…Physicians do not consider emails suitable for investigation of new symptoms or discussion of mental issues. (Gaster et al, 2003) More than two thirds agree that it is appropriate to communicate with a patient by email about appointment scheduling, medication refills and informing patient about normal results; while half of the physicians only consider disease management and dose adjustment and discussion of abnormal results are appropriate. (Gaster et al, 2003) Both HIPAA regulations and AMA guidelines emphasize greatly confidentiality and privacy; yet most physicians and patients did not express this concern.…”

Prevalence of basic information technology use by U.S. physicians

“…11,12 Prior surveys of physician IT use have been limited to single practice settings (often academic centers) or single technologies (such as e-mail communication). [13][14][15][16][17][18][19][20][21][22] To more fully address the issue of basic IT adoption by physicians actively engaged in patient care, we surveyed a national sample of primary care and specialist physicians to determine frequency of e-mail communication with patients or with other providers, online access to continuing medical education (CME) programs or professional journal web sites, and ''realtime'' computerized decision support (CDS) during patient care. These 5 technologies are technically simple to use and substantially less expense to adopt than EHRs.…”