• Government
• Profession
• Business
• Opinion
• Health

• Health reform
• H1N1
• P4P
• EMRs
• Medicare
• Liability
• AMA House
• » More

• Book Excerpt
• Business Pitch
• Meetings
• » More

• Contract Language
• Ethics Forum
• In the Courts
• Practice Management
• Technically Speaking
• » More

• Issue dates
• Regions
• Health plans
• Sections
• News briefs
• Columns
• Editorials
• Letters
• Writers
• Other years

• Search tips
• E-mail alert
• Radio
• RSS
• Mobile
• Subscribe
• Institutions
• Staff directory
• Advertising
• Permissions
• Reprints
• News media
• Site guide
• Useful links
• About
• Premium
• Contact

E-mail use requires awareness, guidelines

The AMA has guidelines with advice on how to handle patient-doctor e-mail.

Editorial. April 2, 2001.

• PRINT|
• E-MAIL|
• RESPOND|
• REPRINTS|
• SHARE

To borrow a word from medicine, e-mail use is contagious.

Doctors are hardly immune. Estimates vary on exactly how many physicians use e-mail -- a good bet would be in the hundreds of thousands -- and it's easy to see why. It's so simple to quickly dash off a message or to receive one.

But things suddenly stop being so simple when that message is to or from a patient. Each and every one of those patient-doctor e-mail messages entails a whole constellation of concerns -- privacy, liability, timeliness, patient record keeping and more.

Although the numbers on patient-doctor e-mail are small now, they will likely only go up. Just last month, the Institute of Medicine's "Crossing the Quality Chasm" report called for increased use of patient-doctor e-mail.

Ground rules are needed. For example, patient and physician expectations on how soon an e-mail should be answered may be hours or even days apart. Unless those expectations are put into synch, problems are inevitable.

Last year, the AMA developed guidelines that provide insight into the complexities and offer some solutions. Suitably, given the topic, they are available online.

Some highlights from the guidelines: Tell patients about practice policies on e-mail privacy and confidentiality, including whether messages will be printed out and filed. Patients should be informed of the turnaround time for messages. They should also be told which types of messages are on or off limits; for example, prescription refill requests may be acceptable, but perhaps not especially sensitive subjects like HIV or mental health. Patients should be asked to reply to messages so the doctor will know if the e-mail was received and read. [...]