Overview - Use of e-Mail in Medical Practice


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The ability to communicate with one's physician has a number of potential benefits and inherent risks. This presentation outlines an approach towards the use of e-mail in medical practice.

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Overview - Use of e-Mail in Medical Practice

  1. 1. Using e-mail in a Medical Practice An Overview of Risks and Benefits January 28, 2007 Dr. Alan Brookstone
  2. 2. Objectives of presentation <ul><li>Develop an understanding of the risks and potential benefits of the use of e-mail in a medical practice </li></ul><ul><li>NOT promote use of insecure e-mail for confidential patient information </li></ul>
  3. 3. e-Mail <ul><li>How many use e-mail? </li></ul><ul><ul><li>For communication with colleagues? </li></ul></ul><ul><ul><li>For communication with patients? </li></ul></ul><ul><li>Differences between the US and Canada </li></ul>Doctor Payer Patient Patient Doctor Managed Care
  4. 4. Theoretical Situation <ul><li>Becoming overloaded with messages, you begin to look for alternative methods to communicate with patients to reduce after-hours work </li></ul><ul><li>Is e-mail an effective tool? </li></ul><ul><li>What are the issues? </li></ul>
  5. 5. Motivators <ul><li>Critical vs. Non-critical medical conditions </li></ul><ul><li>Difficult to reach providers </li></ul><ul><li>Increasingly mobile patients </li></ul><ul><li>Everyone is busy </li></ul><ul><li>Easy access to computers or wireless devices </li></ul><ul><li>Changing expectations </li></ul>
  6. 6. Areas of Concern <ul><li>Sensitive medical conditions – e.g STD results/cancer </li></ul><ul><li>Medical emergencies </li></ul><ul><li>Time sensitive issues </li></ul>
  7. 7. Legal Issues <ul><li>Was the e-mail received? </li></ul><ul><li>Was it read? </li></ul><ul><li>Was it sent to the right person? </li></ul><ul><li>Did anyone else have access? </li></ul><ul><li>Was there a response? </li></ul><ul><li>Have you placed a copy in patient record? </li></ul><ul><li>Remember, you’re leaving a time stamp! </li></ul>
  8. 8. Imagine if . . . <ul><li>You send a confidential e-mail to the wrong patient </li></ul><ul><li>Patient receives e-mail from you which you did not send </li></ul><ul><li>E-mail you sent is intercepted and distributed </li></ul>
  9. 9. Can You Justify using E-mail? <ul><li>Will E-mail </li></ul><ul><ul><li>Reduce telephone time and reduce costs? </li></ul></ul><ul><ul><li>Improve patient care? </li></ul></ul><ul><ul><li>Improve communication and access? </li></ul></ul><ul><ul><li>Fit into your pattern of practice? </li></ul></ul><ul><li>Security is a concern </li></ul><ul><li>Is there a demand in your practice? </li></ul>
  10. 10. What is Appropriate? <ul><li>Booking non-urgent appointments? </li></ul><ul><li>Change of address information? </li></ul><ul><li>Prescription renewals? </li></ul><ul><li>Special circumstances </li></ul><ul><ul><li>Terminal illness – dosage management?? </li></ul></ul><ul><ul><li>Patients traveling away from home? </li></ul></ul>
  11. 11. Consent <ul><li>Agreement from patient that it can be used </li></ul><ul><li>Format and length of e-mails </li></ul><ul><li>Response times </li></ul><ul><li>Define appropriate use </li></ul><ul><li>Must be included in patient record </li></ul>
  12. 12. Guideline to Use <ul><li>Develop an e-mail policy </li></ul><ul><ul><li>Office signs </li></ul></ul><ul><ul><li>Letter to patients </li></ul></ul><ul><ul><li>Brochure </li></ul></ul><ul><ul><li>Printed on back of appointment cards </li></ul></ul><ul><ul><li>Signature for your E-mail communications </li></ul></ul><ul><li>Consent issue </li></ul><ul><li>Offer as an option to telephone in specific situations </li></ul>
  13. 13. Develop an e-mail Policy
  14. 16. Conclusions <ul><li>Appropriate use is essential </li></ul><ul><li>Will depend on willingness of provider to send and patient to receive </li></ul><ul><li>Can be used complimentary to other methods </li></ul><ul><li>Guidelines and patient education necessary </li></ul>
  15. 17. http://www- med.stanford.edu/shs/smg/email.html
  16. 18. Handheld / Wireless E-mail <ul><li>Devices currently exist that can meet your needs </li></ul><ul><li>How do they fit into workflow </li></ul><ul><li>Can you get the data back in the patient record? </li></ul><ul><li>Is wireless e-mail practical </li></ul><ul><li>Short Messaging Service (SMS)? </li></ul>
  17. 19. Palm Treo 650                                                                                                                            
  18. 20. RIM Blackberry 8700g
  19. 21. Professional Communications <ul><li>E-mail between colleagues – referral letters, consultation requests, digital images? </li></ul><ul><li>The use of Short Messaging Service </li></ul><ul><li>Receiving updates, alerts and news bulletins on your phone </li></ul>
  20. 22. Bottom Line <ul><li>E-mail can be very useful in a medical practice </li></ul><ul><li>However </li></ul><ul><ul><li>Requires thoughtful planning </li></ul></ul><ul><ul><li>Solid office policies </li></ul></ul><ul><ul><li>Support materials – Web based and Print </li></ul></ul><ul><ul><li>Secure e-mail for communication of sensitive patient information </li></ul></ul>