Abstract
Physician-patient interaction through email poses several concerns regarding the security, efficiency, and misinterpretation of critical information. Incoming emails received by a single university-based physician in 2013 were analyzed in order to determine whether a general non-patient specific email is appropriate for patient use. Emails received were divided into seven categories: Informational, Academic, Advertisement, Organization/Department/ University, Mission Critical, Personal, and Patient. A total of 9,102 emails were received and read by the physician, with an average of 25 emails per day, out of which 823 (9%) emails were directly sent by patients. The total time spent reading emails was five days, seven hours, and 24 minutes. General email is not an effective means of streamlining physician-patient communication. Non-essential emails, which represent a majority of incoming messages, decrease the productivity of physicians and prevent them from responding to urgent messages in a timely manner. Additionally, this creates the chance for critical patient information getting lost with the volume of received emails. This could be detrimental to patient care and satisfaction. Recently, an online portal was instated to provide a method of secure communication, and less than five patient emails were received in the physician’s personal email since then.
Highlights
Follow-up appointments tend to be scheduled based on calendar availability rather than on patient need, leading to an increased necessity for doctor-patient communication between appointments [1]
Physicians’ are primarily concerned about: 1) the lack of security measures in sending/receiving emails, 2) increased time commitment and effort required by doctors to read and respond to emails, 3) risk and liability stemming from a miscommunication or misunderstanding of vital information, 4) likelihood of patients consulting via email for trivial issues, and 5) increased possibility of crucial information being lost within the volume of emails that flood a physician’s inbox [2,3]
The potential for sensitive patient information being delivered through non-secure emails puts the physician at an increased risk of litigation or violation of Health Insurance and Portability and Accountability Act (HIPAA) [2]
Summary
Follow-up appointments tend to be scheduled based on calendar availability rather than on patient need, leading to an increased necessity for doctor-patient communication between appointments [1]. The Federal Health Insurance and Portability and Accountability Act (HIPAA) requires that electronic communication regarding patient health be protected at all times [4]. This means that electronic messages need to be encrypted or delivered through a secure portal. Out of all the patients that use email to contact their physicians, it is estimated that up to 90% tend to send critical information [4]. Despite these security issues, approximately 1%-10% of patients in the United States communicate with their physicians through email [6]
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