Electronic Communication with Patients
Annabelle Rae C. Norwood, MD
Electronic communication has now become a routine part of clinical practice. A lot of non-urgent communication with patients and their providers now occur through on-line channels such as secure messaging and e-mails. In particular, MaineHealth is highly encouraging patients to sign-up for and utilize MyChart, wherein patients can directly send messages to their providers. As such, there may be a need for medical educators and health care institutions to provide more guidance and education about this topic. (1) It has been shown that electronic communication with patients, can actually improve patient care and outcomes such as improved medication adherence (2). However, everyone communicating with patients through these online portals should be cognizant of privacy, confidentiality concerns, and HIPAA rules. Therefore, communication with patients should only occur in secure networks and not through personal e-mails, and definitely not social media. Institutions themselves, however, should also reinforce with patients that online communication should be only about non-urgent matters such as refill requests, that messages should be brief and descriptive and that these messages are going to be a part of the medical record (3).
There are also certain business e-mail etiquette (4) that may be applied to answering patient communication.
- Use a professional salutation. “Hi”, “Hello” or a more formal “Dear (name)” are all appropriate salutations. “Hey”, “Hiya” or “Yo” are not.
- Try to answer messages in a timely manner. Two business days is usually standard. It may also to just help the patient acknowledge that you have received the message, even if you don’t have an answer right away.
- Don’t send angry messages. In that rare instance where a patient were to send offensive or threatening e-mail, in one study analyzing secure messages in two Veterans Administration health care centers, offensive or threatening messages only comprised 0.2% of all messages sent. (5) Formulate an appropriate response when you’re calmer is better. It would also be good to bring up this situation to your supervisor or team on how best to address this patient’s concern.
- Avoid using abbreviations like LOL, writing in all CAPS, using emoticons and using a string of exclamation points!!!!! These are not professional.
- Proofread your messages before sending them.
- A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations. Joy L Lee, Marianne S Matthias, Nir Menachemi, Richard M Frankel, Michael Weiner. 4, 2018, Journal of the American Medical Informatics Association, Vol. 25, pp. 413-418.
- Creatine a synergy effect: A cluster randomized controlled trial testing the effect of a tailored multimedia intervention on patient outcomes. Annemiek J Linn, Lisetvan Dijk, Julia C M van Weert, Beniam G Gebeyehu, Ad A van Bedegraven, Edith G Smit. 8, s.l. : Patient Education and Counseling, 2018, Patient Education and Counseling , Vol. 101, pp. 1419-1426.
- Expanding the gidelines for electronic communication with patients: Application to a specific tool. Stephanie L Prady, Dierdre Norris, John E Lester, Daniel B Hoch. 4, 2001, Journal of the American Medical Informatics Association, Vol. 8, pp. 344-348.
- Whitmore, Jacqueline. The Do’s and Don’ts of Email Etiquette. [Online] 2016. [Cited: May 28, 2019.] https://www.entrepreneur.com/article/272780.
- An analysis of patient-provider secure messaging at two Veterans Health Administration medical centers: message content and resolution through secure messaging. Stephanie L Shimada, Beth Ann Petrakis, James A Rothendler, Maryan Zirkle, Shibei Zhao, Hua Feng, Gammae M Fix, Mustafa Ozkaynak, Tracy Martin, Sharon A Johnson, Bengisu Tulu, Howard S Gordon, Steven R Simon, Susan S Woods. 5, 2017, Journal of the American Medical Informatics Association, Vol. 24, pp. 942-949.