Patients e-mail -- but they still keep calling

Electronic mail has been touted as a way to improve physician-patient communication. A study finds it can. But that doesn't mean it'll save you time.

By Tyler Chin, AMNews staff. June 10, 2002.

After he began exchanging electronic mail with his patients, James Kluzinski, MD, a family physician in Indianapolis, got requests for a refill "for the white pill."

He had, of course, previously told his patients that any refill request made online should include the name of the medication, as well as the pharmacy's phone number.

Dr. Kluzinski then would have to ask a staff member to pull the chart and/or telephone the patient to confirm or determine just what medication was needed.

"I found e-mails to be time-consuming. They generated an awful lot of calls," Dr. Kluzinski said. So he discontinued e-mail access for patients six months after offering that option.

A study by researchers at the University of Michigan Health System in Ann Arbor appears to confirm that Dr. Kluzinski's experience with physician-patient e-mail isn't an aberration, and suggests that e-mail may not be the efficiency driver that some in the industry believe it can be.

The large, randomized study found that e-mail did not offset the volume of patient phone calls and office visits, said Steven Katz, MD, an internist at the University of Michigan who directed and co-authored the study published in the May American Journal of Managed Care.

The study, conducted over a 10-month period ending in July 2001, split participants -- 98 doctors and about 750 patients at two primary care clinics -- into two groups.

The intervention group used a "triaged" e-mail system under which e-mails from patients were first read and handled by nurses while those in the control group used conventional, uncontrolled e-mail, going straight to the physician. [...]