This document provides guidelines for the clinical use of electronic mail with patients. It outlines advantages such as accelerated communication, convenience, and the ability to simultaneously send health information to many patients. However, it also stresses the importance of maintaining patient privacy and obtaining informed consent. The guidelines recommend identifying the patient and category of email, printing and filing all messages, using auto-reply confirmations, and avoiding urgent matters or sharing of accounts over unsecured networks.

1. Guidelines for Clinical Use of Electronic Mail with Patients

2. Medical communication between Patient-Doctor is considered privileged, and demands strict confidentiality. Features of medical communication- 1) Effective interaction between the clinician and patient, 2) Observance of medicolegal prudence

3. Advantages of using e-mail Accelerates communication of the written word. Allows communication any time of day. Does not need the attention of both parties at the same time.

4. Advantages… Provides a mechanism for sending the same health education information simultaneously to many patients, Is simple, convenient and inexpensive to use, Enables physicians to direct patients to health information on the Internet.

5. Informed consent for use of e-mail. Guidelines. * Provide instructions for when and how to escalate to phone calls and office visits. * Describe security mechanisms in place. * Indemnify the health care institution for information loss due to technical failures. * Waive encryption requirement, if any, at patient's insistence.

6. Practical implications - Patients to put their name and patient identification number in the body of the message. Print all messages, with replies and confirmation of receipt, and place in patient's paper chart.

7. Categorize emails Patients to put category of transaction in subject line of message for filtering: eg. “ prescription,” “ appointment,” “ medical advice,” “ billing question”.

8. Security Never forward patient-identifiable information to a third party without the patient's express permission. Do not share professional e-mail accounts with family members. Do not use unencrypted wireless communications with patient-identifiable information. Perform at least weekly backups of mail onto long-term storage.

9. Do not use e-mail for urgent matters . Both parties to use Auto-reply tool to confirm receipt of message. Maintain a mailing list of patients, but Do not send group mailings where recipients are visible to each other. Use blind copy feature in software.

10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC61279/?tool= pubmed https://www.amia.org/mbrcenter/pubs/email_guidelines.asp Soul Thang Composed by: Scott P. Schreer, Stephen A. Love.

11. Dr.Neelesh Bhandari MBBS, MD (Path.) Sr. Advisor (Medical communications) edrneelesh Digital-medicine.blogspot.com