Using e-mail in a Medical Practice An Overview of Risks and Benefits January 28, 2007 Dr. Alan Brookstone

Objectives of presentation Develop an understanding of the risks and potential benefits of the use of e-mail in a medical practice NOT promote use of insecure e-mail for confidential patient information

Develop an understanding of the risks and potential benefits of the use of e-mail in a medical practice

NOT promote use of insecure e-mail for confidential patient information

e-Mail How many use e-mail? For communication with colleagues? For communication with patients? Differences between the US and Canada Doctor Payer Patient Patient Doctor Managed Care

How many use e-mail?

For communication with colleagues?

For communication with patients?

Differences between the US and Canada

Theoretical Situation Becoming overloaded with messages, you begin to look for alternative methods to communicate with patients to reduce after-hours work Is e-mail an effective tool? What are the issues?

Becoming overloaded with messages, you begin to look for alternative methods to communicate with patients to reduce after-hours work

Is e-mail an effective tool?

What are the issues?

Motivators Critical vs. Non-critical medical conditions Difficult to reach providers Increasingly mobile patients Everyone is busy Easy access to computers or wireless devices Changing expectations

Critical vs. Non-critical medical conditions

Difficult to reach providers

Increasingly mobile patients

Everyone is busy

Easy access to computers or wireless devices

Changing expectations

Areas of Concern Sensitive medical conditions – e.g STD results/cancer Medical emergencies Time sensitive issues

Sensitive medical conditions – e.g STD results/cancer

Medical emergencies

Time sensitive issues

Legal Issues Was the e-mail received? Was it read? Was it sent to the right person? Did anyone else have access? Was there a response? Have you placed a copy in patient record? Remember, you’re leaving a time stamp!

Was the e-mail received?

Was it read?

Was it sent to the right person?

Did anyone else have access?

Was there a response?

Have you placed a copy in patient record?

Remember, you’re leaving a time stamp!

Imagine if . . . You send a confidential e-mail to the wrong patient Patient receives e-mail from you which you did not send E-mail you sent is intercepted and distributed

You send a confidential e-mail to the wrong patient

Patient receives e-mail from you which you did not send

E-mail you sent is intercepted and distributed

Can You Justify using E-mail? Will E-mail Reduce telephone time and reduce costs? Improve patient care? Improve communication and access? Fit into your pattern of practice? Security is a concern Is there a demand in your practice?

Will E-mail

Reduce telephone time and reduce costs?

Improve patient care?

Improve communication and access?

Fit into your pattern of practice?

Security is a concern

Is there a demand in your practice?

What is Appropriate? Booking non-urgent appointments? Change of address information? Prescription renewals? Special circumstances Terminal illness – dosage management?? Patients traveling away from home?

Booking non-urgent appointments?

Change of address information?

Prescription renewals?

Special circumstances

Terminal illness – dosage management??

Patients traveling away from home?

Consent Agreement from patient that it can be used Format and length of e-mails Response times Define appropriate use Must be included in patient record

Agreement from patient that it can be used

Format and length of e-mails

Response times

Define appropriate use

Must be included in patient record

Guideline to Use Develop an e-mail policy Office signs Letter to patients Brochure Printed on back of appointment cards Signature for your E-mail communications Consent issue Offer as an option to telephone in specific situations

Develop an e-mail policy

Office signs

Letter to patients

Brochure

Printed on back of appointment cards

Signature for your E-mail communications

Consent issue

Offer as an option to telephone in specific situations

Develop an e-mail Policy

Conclusions Appropriate use is essential Will depend on willingness of provider to send and patient to receive Can be used complimentary to other methods Guidelines and patient education necessary

Appropriate use is essential

Will depend on willingness of provider to send and patient to receive

Can be used complimentary to other methods

Guidelines and patient education necessary

http://www- med.stanford.edu/shs/smg/email.html

Handheld / Wireless E-mail Devices currently exist that can meet your needs How do they fit into workflow Can you get the data back in the patient record? Is wireless e-mail practical Short Messaging Service (SMS)?

Devices currently exist that can meet your needs

How do they fit into workflow

Can you get the data back in the patient record?

Is wireless e-mail practical

Short Messaging Service (SMS)?

Palm Treo 650

RIM Blackberry 8700g

Professional Communications E-mail between colleagues – referral letters, consultation requests, digital images? The use of Short Messaging Service Receiving updates, alerts and news bulletins on your phone

E-mail between colleagues – referral letters, consultation requests, digital images?

The use of Short Messaging Service

Receiving updates, alerts and news bulletins on your phone

Bottom Line E-mail can be very useful in a medical practice However Requires thoughtful planning Solid office policies Support materials – Web based and Print Secure e-mail for communication of sensitive patient information

E-mail can be very useful in a medical practice

However

Requires thoughtful planning

Solid office policies

Support materials – Web based and Print

Secure e-mail for communication of sensitive patient information