E-mail one of technology benefits touted at AMA forum

Physicians should embrace technology to improve health care quality, said speakers at a recent forum on virtual medicine.

By Damon Adams, amednews staff. April 16, 2001.

In today's technology-driven world, many patients want to communicate by e-mail with their doctors.

In fact, some are willing to change physicians to find one who exchanges e-mail with patients.

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"E-mail can be very useful and a nice adjunct to the patient-doctor relationship," said Daniel Z. Sands, MD, clinical director of electronic patient records and communication for CareGroup Healthcare System in Boston. Dr. Sands is also an instructor in medicine at Harvard Medical School.

He was among the featured speakers at the "Clinical Quality Improvement Forum: Virtual Medicine," held in suburban Chicago in March. The forum was sponsored by the Division of Clinical Quality Improvement of the American Medical Association. Topics included e-mail with patients, electronic medical records and data collection, and tracking quality of medical care.

The forum comes at a time when more physicians are examining the relationship between technology and medicine.

A Harris Interactive survey in February said the number of physicians using e-mail and the Internet was increasing. It found that 55% of practicing physicians communicate by e-mail with their colleagues, while 34% use it to talk with support staff. Yet, despite the trend, only 13% send e-mail to their patients.

Some doctors have security concerns about e-mail and worry about liability issues, Dr. Sands said. But e-mail improves patient access and communication, he added.

"We're shifting messaging from the telephone to e-mail," he said.

An Institute of Medicine report released in March said technology must play a key role in overhauling the health care delivery system. The nonprofit institute's report, "Crossing the Quality Chasm: A New Health System for the 21st Century," recommends over the next decade giving patients more control over their own care and allowing them to receive it whenever they need it -- 24 hours a day -- through e-mail communication with doctors if necessary.

Use of information technology would reduce cumbersome paper records, promote e-mail communication between doctor and patient and save time and money, the report said.

The IOM report calls on the federal government, health care organizations, insurers and others to work together in a nationwide effort to build a technology-based information infrastructure.

Some doctors said easy access may place patient confidentiality at risk if medical records or e-mails to patients get in the wrong hands. Putting a dollar figure on installing technology is difficult, physician groups say, and varies according to the size of the medical practice.

At the forum, Prince K. Zachariah, MD, shared how some Mayo Clinic locations have converted to electronic record systems, with patient charts and other medical information stored by computer.

"Overall, this is going to improve the care of your patients," said Dr. Zachariah, of Mayo Clinic Scottsdale (Ariz.). "What is the net savings in dollars? Millions."

Bruce Bagley, MD, board chair of the American Academy of Family Physicians, told forum attendees that electronic records add to office efficiency and reduce errors and miscommunication. He said physicians could start simply, with a handheld computer that can contain a wealth of illness and drug information.

Projects such as SKOLAR, M.D., a Web site for physicians that was created by Stanford University, enable doctors to find clinical information on the Internet.

"They're using it to make better decisions [for treatment]," said Kenneth Melmon, MD, chief medical officer for SKOLAR, M.D., during a presentation at the forum. "The more knowledge you've got, the better off the patient is going to be."