Using e-mail is a convenient way to boost patient satisfaction and improve physician efficiency, according to Pennsylvania State University College of Medicine researcher Shou Ling Leong, M.D., the lead author of a report on doctor-patient communication in the May/June issue of the Journal of the American Board of Family Practice.
"E-mail is an important tool," said Leong, an associate professor of family and community medicine at the university. "Patients like it, physicians like it, and it should be part of the redesign to make healthcare more efficient."
The study compared patient communication with four doctors who used e-mail for nonurgent messages and four who did not use e-mail at all to communicate with patients. Because of its small size, Leong said the study was more useful for identifying trends than for generating statistics. She said the most important of the trends were that patient satisfaction increased and that it took physicians less time to reply to e-mails than telephone messages.
The four physicians using e-mail received 299 e-mails between December 2001 and July 2002. Most were condition updates (32%), short medical consultations (31%) and medication questions (16%).
Leong said her own patients regularly send e-mails giving a few weeks' worth of blood pressure or blood glucose readings. This allows her to fine-tune their medications while saving patients a visit to the doctor's office, she said. She added that e-mail is helpful in managing the multiple conditions of her elderly patients who e-mail updates about their visits to specialists. "That saves a lot of time for their next visit," she said. "Instead of having them tell me what's going on, I already know."
Leong suggests that e-mail should be part of a technology package that includes electronic medical records and Web sites where patients can go for information to reinforce discussions that took place in the doctor's office.
"That's how I'd like to see it happen," she said. "E-mail as a piece by itself may not be that effective."
One inefficiency of using e-mail on its own, Leong said, is that messages need to be printed and added to a patient's file. With EMRs, this is done automatically.
Leong said that barriers to wider use of e-mail include reimbursement issues and physicians' fears that increasing their accessibility "may blossom into a huge amount of new work."
Bruce Bagley, M.D., medical director for quality improvement at the American Academy of Family Physicians, agreed with Leong and said the asynchronous nature of e-mail -- which is not dependent on both parties communicating at the same time -- adds to the satisfaction of both patient and physician. "Patients get better -- or perceive they get better -- service because they aren't being kept on hold or sitting around waiting for the phone to ring," Bagley said. "That's a big thing patients complain about."
He added that his organization advocates the use of e-mail for nonemergency communication. "We're all for electronic communication," Bagley said. "As long as they don't use it for chest pain, we're all set."
Read the report.
