You could come up with many reasons why most doctors (two-in-three, according to recent surveys) won’t email their patients:
-They’re crunched for time
-They don’t want to violate privacy laws
-They don’t get reimbursed for it
-It could make things more confusing since things can get misinterpreted over email more easily
That’s a few off the top of my head. I’d say, in some fashion they’re all valid concerns. Workflow, privacy, reimbursement, and clarity are things you can’t take for granted.
But guess what, physicians? They’re not an excuse to avoid doing it. You’re going to have to learn to integrate electronic communications with your patients into the workflow anyway.
It’s not just me saying this. A recently released study in Health Affairs confirms what every physician should now know to be true: Electronic communications between physicians and patients should be considered part of their job description.
The study, from researchers at the Beth Israel Deaconess Medical Center (BIDMC) in Boston, examined trends in secure email messaging between physicians. Looking at a large academic health center, the researchers analyzed secure emails in the patient portal over a 10-year period.
What they found was that 49,778 patients (22.7 percent of all patients seen within the system) had enrolled in the portal. Of those, 36.9 percent of enrolled patients (8.4 percent of all patients) had sent at least one message to a physician. During the study period, the number of messages to physicians tripled. For every 100 patients, the number of messages stabilized at nearly 20 toward the end.
It’s not a ton, but the data and trends in reimbursement are enough for the researchers to recommend that physicians integrate electronic communication into their workflow.
"We saw that over time as patients moved through an early adopter phase and settled in to the idea of communicating this way, the overall number of messages per patient didn't continue to rise, but plateaued over time. However, as more patients enrolled in the portal, physicians' inboxes increased," said the study's lead author, BIDMC's Bradley Crotty, M.D.
We know that patient portals, in general, are far from impressive. But email isn’t a new technology. Secure email messaging systems are aplenty. No one is telling physicians to use a hover craft. When they do, studies have shown that it’s helped improve quality of care. Don’t believe me? Just ask the Military Health System. The troops wouldn’t lie.
We know that many patients are not going to use a computer to interact with their health car—if you don’t engage them. It takes a bit of effort. Studies have shown that discussing portals with the patient has increased usage rates. We also know that many patients don’t even know they have a portal to use or a way of communicating with their doctor outside the office.
More than anything else though, we know that a good chunk of patients, ultimately, are interested in this capability. In fact, that survey says 93 percent of adults are interested. And guess what? Physicians should want this to work. Can you imagine decreasing the number of inconsequential visits thanks to electronic communications? That should make that whole time-crunching problem easier.
Will there be hiccups, in terms of interpretation and clarity, if you’re communicating with patients through email? Absolutely. But it’s not like that doesn’t happen when physicians and patients meet face-to-face. Portals will have to improve. Kinks will have to be worked out. There is no getting away from that. But this is a necessary evolution of physician-patient encounters in the 21st century.
When you’re a doctor in 2014, you have a lot of people telling you what to do. I understand that it’s got to be frustrating. There are a lot of things that deserve resistance in some capacity.
Emailing in the context of secure messaging? It’s not one of them.