Can E-Mail Enhance Doctor-Patient Communication?

E-mail has become essential for modern communication. Love it or hate it, most of us spend some part of our day communicating with business colleagues, family or friends on e-mail. It’s an efficient way to interact.
One area where e-mail has not taken hold, however, is health care. Although doctors communicate with one another via e-mail, relatively few accept e-mail from their patients. As a result, to get through to the doctor, most patients need to call the office. After making their way through the phone tree, they may be able to speak to a receptionist. The most likely response will be that the doctor is busy seeing patients and will call back later.
Fair enough. But that does set the stage for a frenetic game of phone tag later in the day. When the doctor does call back to answer your question, renew your prescription or give you the results of last week’s test, are you sitting by the phone? Or is that the moment you stepped out to run an errand? If so, you’ll need to call back when you get in, and start the whole process all over from the beginning.
One of the reasons doctors are often reluctant to give out their e-mail address to patients is a fear that they will be inundated by long messages and questions. The time that is spent answering such queries is often not reimbursed. As a result, about the last thing a busy doctor wants to do is read and respond to e-mail at the end of a long day.
Although there is not a lot of research to draw upon, the evidence does not support these fears. In one study of a pediatric rheumatology practice, e-mail “enables physicians to answer medical questions with less time spent compared with telephone messaging” (Pediatrics, Oct. 2007).
Another study provided patients guidelines for e-mailing their doctors and reviewed 3,000 messages in the course of a year (Journal of the American Medical Informatics Association, July-August, 2004). Almost all the messages were “concise, formal, and medically relevant.”
The best argument for e-mail between patients and their physicians would be improved care. That is precisely what researchers at Kaiser Permanente found in a recent study (Health Affairs, July, 2010). They examined more than 500,000 e-mail strings between system doctors and patients between October 2007 and December 2008. Patients with diabetes scored better on measures of health quality if they communicated with their doctors by e-mail.
E-mail allowed patients to let doctors know of changes in their condition, ask about lab results and inquire about drug dosages. The doctors at Kaiser Permanente average between two and twelve messages in a work day.
Kaiser Permanente patients have access to e-mail to their physicians via a patient portal, a Web-based system that also permits them to look at their pharmacy records, get laboratory test results and find self-care instructions.
As we become accustomed to using the Web to book our airplane tickets, pay our bills and buy tickets to concerts, many people would welcome the ability to use this technology to communicate with their health care providers.