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TECHNOLOGY & MEDICINE
ALYSE  HOYLE
E-Mail in the Office

"Time is money.” Thus spoke Benjamin Franklin in his Advice to a Young Tradesman, over two hundred years ago. In the centuries following, this proverb has grown in truth and in popularity, especially in the health care industry. Providers today scramble to meet health care regulations and still provide the highest level of patient care possible.
Physicians now find themselves in a unique position. Technology has provided a multitude of ways to increase efficiency and decrease the amount of time they need to pursue certain tasks; however, this same technology must
be monitored closely in its use. Due, in part, to high patient demand, physicians have turned to e-mail as a means of increasing not only their provider-patient communication, but also in decreasing turnaround time for patient care and practice profit. But what are the risks? Or rather, what are the benefits? Many physicianswith whom I speak find themselves reluctant to adopt this new avenue of communication. In all actuality, however, the health care industry is one of the last to adopt e-mail communication as a valuable resource. In today’s world, many of us receive our bills and other important documentation via e-mail. It decreases our wait time and the amount of time that could elapse if there were a problem with any of our accounts. Are there risks? Yes. But there are risks no matter what form of communication we choose to implement. In a physician setting, there are steps that can be taken to mitigate these potential problems. HIPAA permits providers to communicate with their patients via e-mail as long as reasonable precautions are taken. Many of these safeguards are simple: verifying e-mail addresses prior to sending, or even sending an e-mail to patients first, confirming their e-mail prior to releasing any information. Additional information regarding the security measures for HIPAA can be found by referencing the HIPAA Security Rule at 45 C.F.R. part 164, Subpart C. 1

One safeguard is to employ a patient portal. These are secure websites linked to the physician’s practice that allow patients to communicate via a secure link to the provider. The patient portal allows encrypted messages to pass between the physician and patient. Oftentimes providers must issue login information to patients to access the portals. Many of these portals can link with certain EMR technologies, and providers can then use this portal to obtain patient history, patient medications and even certain vital signs, and incorporate these into their EMR or practice management systems. Physicians can utilize tools like this to increase their efficiency and help to move their practice into a more profitable, ecologically beneficial situation. More importantly, it opens a channel directly between the provider and the patient. This channel can bring several long-lasting benefits to the provider.

Establishing a patient-physician relationship
In an industry where everything seems to be regulated into time allotments, allowing patients to communicate with their physician gives them the sense of building a relationship with their provider, without the proverbial clock ticking away as they express their concerns. It encourages patients to articulate any anxiety regarding their health care follow-up, and it allows the provider to offer encouragement and direction about a healthier lifestyle. By cultivating this relationship, the physician is also actively encouraging patient loyalty. The health care industry was built upon the patient-doctor relationship. The patient portal is giving patients back their relationship with their health care provider, and with this relationship comes a sense of loyalty. This loyalty increases provider-patient retention and promotes a thriving practice. Many physicians are concerned, though, that they might lose control of patient care, or worse, that a patient may resort to sending an e-mail rather than calling emergency services in an emergency setting. Providers should address this at the onset of patient portal e-mail communication. They (or their office staff) should sit with the patient and firmly explain the point of e-mail communication, namely that it should not be used for emergencies or for serious health care concerns.

Follow-up care
This is not to say that this form of communication should replace one-on-one, physician-patient office visits. Most physicians bulk at e-mail communication citing that they are unable to read the patient as they need to. Facial expressions, body language and behavioral nuances are key points that many providers rely upon as they make their diagnosis and assessment during patient visits. E-mail communication was never meantto replace the office visit. E-mail communication should be used to enhance an office visit and to provide the most prompt and thorough follow-up possible. Because the health care industry is so focused on delegating time on specific procedures and office visits, patient follow-up care is often a casualty. E-mail between the provider and the patient can help to alleviate this problem. Specific follow-up care for any procedures, instruction for new medication or directions to follow-up with an office visit can all be communicated in e-mail. This will also decrease the amount of time a physician’s staff must spend tracking down a patient and wasting resources on missed calls and messages.

Efficient practice management
Much of an office staff’s time is spent communicating with the patient or, rather, trying to. Many practices find themselves overwhelmed with the sheer volume of calls and follow-up that must be addressed day to day. E-mail communication can assist in alleviating some of the burden that this follow-up care bestows upon the practice. Many physicians find it useful to set aside certain times to respond to these e-mails inquiring about refills or follow-up appointments and often allow their staff to assist in this area. Providers can also utilize inter-office e-mail communication as a means to increase efficiency among office staff. Most EMRs offer a secure e-mail available for inter-office use only. This tool can assist in assigning patient follow-up care and certain office tasks, and also provide a means of tracking these assignments for review later.

Provider use of e-mail can benefit providers in several areas, most of which can be directly linked to their revenue. By utilizing this key resource, providers can successfully migrate into the 21 st  century and bring their practice forward in patient care and in practice management. It is not a “risk free benefit,” but very few resources today are. For a provider whose “time is money,” it is certainly not an avenue to be disregarded.

1 http://www.hhs.gov/ocr/privacy/hipaa/faq/health_information_technology/570.html.

http://www.acms.org/august-bulletin-available-2/ 
 


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