Use of email in a family practice setting: opportunities and challenges in patient- and physician-initiated communication

6-Step Weight Loss Center, 13191 Starkey Rd, Suite A-3, Largo, FL 33773, USA.
BMC Medicine (Impact Factor: 7.25). 02/2006; 4(1):18. DOI: 10.1186/1741-7015-4-18
Source: PubMed


Electronic mail (email) has the potential to improve communication between physicians and patients.
We conducted two research studies in a family practice setting: 1) a brief, anonymous patient survey of a convenience sample to determine the number of clinic patients receptive to communicating with their physician via email, and 2) a randomized, controlled pilot study to assess the feasibility of providing health education via email to family practice patients.
Sixty-eight percent of patients used email, and the majority of those (80%) were interested in using email to communicate with the clinic. The majority also reported that their email address changed less frequently than their home address (65%, n = 173) or telephone number (68%, n = 181). Forty-two percent were willing to pay an out-of-pocket fee to have email access to their physicians. When evaluating email initiated by the clinic, 26% of otherwise eligible patients could not participate because they lacked email access; those people were more likely to be black and to be insured through Medicaid. Twenty-four subjects agreed to participate, but one-third failed to return the required consent form by mail. All participants who received the intervention emails said they would like to receive health education emails in the future.
Our survey results show that patients are interested in email communication with the family practice clinic. Our feasibility study also illustrates important challenges in physician-initiated electronic communication. The 'digital divide' - decreased access to electronic technologies in lower income groups - is an ethical concern in the use of email for patient-physician communication.

Download full-text


Available from: Kathryn I Pollak, Oct 13, 2015
17 Reads
  • Source
    • "Yes Concerns of security, liability, and confidentiality (8) Whitten et al. 2 (2007) No Leong et al. 11 (2005) No Padman et al. 17 (2010) Yes Tang et al. 19 (2006) Yes Virji et al. 20 (2006) Yes Houston et al. 39 (2004) No Adamson and Bachman 4 (2010) No Siriwardena et al. 27 (2012) No Concerns about reimbursement model (7) Leong et al. 11 (2005) No Whitten et al. 2 (2007) No Padman et al. 17 (2010) Yes Tang et al. 19 (2006) Yes Virji et al. 20 (2006) No Houston et al. 39 (2004) No Mehrota et al. 31 (2013) "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Online technologies offer the promise of an efficient, improved healthcare system. Patients benefit from increased access to care, physicians are afforded greater flexibility in care delivery, and the health system itself benefits from lower costs to provide such care. One method of incorporating online care into clinical practice, called electronic office visits or "eVisits," allows physicians to provide a consultation with patients online. We performed an analysis of the current published literature on eVisits as well as present emerging research describing the use of mobile platforms as the delivery model. We focused on the role of eVisits in acute primary care practice. Materials and methods: A literature review was conducted using electronic databases with a variety of search terms related to the use of eVisits in primary care. Results: Several advantages to eVisit utilization in the primary care setting were identified, namely, improvements in efficiency, continuity of care, quality of care, and access to care. Barriers to eVisit implementation were also identified, including challenges with incorporation into workflow, reimbursement, physician technological literacy, patient health literacy, overuse, security, confidentiality, and integration with existing medical technologies. Conclusions: Only one study of patient satisfaction with eVisit acute primary care services was identified, and this suggests that previous analyses of eVisit utilization are lacking this key component of healthcare service delivery evaluations. The delivery of primary care via eVisits on mobile platforms is still in adolescence, with few methodologically rigorous analyses of outcomes of efficiency, patient health, and satisfaction.
    Telemedicine and e-Health 12/2014; 21(2). DOI:10.1089/tmj.2014.0022 · 1.67 Impact Factor
  • Source
    • "found many patients expect a quicker response from their health care professional when they have greater access to this individual via e-mail or text. In a study on the use of e-mail in family physician practices, 42 % of patients indicated they would pay a fee in order to have access to their health professional via e-mail (Virji et al. 2006). The ability to e-mail a physician can contribute to a sense of better communication with the professional, and patients reported enjoying interacting with their health care professional without a physical consultation (Neville et al. 2004). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the growth in computer and Internet use, marriage and family therapists’ (MFT) use of such technologies to communicate with clients has received limited attention. The purpose of the current research was to understand the frequency and ways in which MFTs are communicating online with clients and identify their level of comfort with online treatments. We administered a survey to practicing MFTs across the US to identify the frequency with which they used online communications with their clients, and the extent to which they felt comfortable using online communications in various treatment modalities. Implications for research, training, and practice are discussed.
    Contemporary Family Therapy 03/2014; 36(1). DOI:10.1007/s10591-013-9284-0
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Telemedicine and e-health includes the delivery of healthcare over a distance through the use of telecommunication technologies. One specific application is the use of `e-visits' within a clinical setting. e-Visits refer to any type of online patient-provider consultation where electronic information is exchanged, particularly involving the transmission via secure servers. Among many others, services such as patient portals and patient-provider e-mail systems fall into this category. Research has shown that patients have a great desire for the ability to communicate with their providers electronically. Despite consumer demand, provider adoption of e-visit technologies has been slow. Though there are many applications currently being piloted across the US, universal diffusion of e-visit technology has not been reached. Reasons for provider hesitation to adopt e-visit technologies include fears of being overburdened by electronic communication, improper use of electronic communication by patients, lack of reimbursement schemes, legal and regulatory issues, and concerns over security, privacy, and confidentiality. Further research is needed to evaluate and document a wide range of key issues regarding e-visits; evidence concerning the impacts on clinical outcomes, access to healthcare, organizational issues, and financial aspects will all be necessary to guide decision making. While it is imperative that research regarding e-visits assesses the impact on providers and patients (at a micro level), it is also essential that it assesses the organizational issues (at a macro level) that are affected by these technologies. Finally, future research should also attempt to more fully understand the financial impacts that e-visit technologies currently have and potentially could have on the healthcare industry. Market forces have historically shown the ability to alter industry structures over time, as demand and need for services increases. As a result, consumers may ultimately drive demand for e-visit services in ways providers will be required to adopt.
    Disease Management and Health Outcomes 01/2007; 15(4):207-214. · 0.35 Impact Factor
Show more