Email communication can be a great tool for your medical practice to communicate with patients quickly and keep them up-to-date with their future appointments or follow-ups. However, when dealing with sensitive or confidential information, it’s imperative that both physician and patient are fully aware of the privacy concerns when communicating over the Internet.
Similar to using cloud medical software, such as EMR, there are a number of potential security issues you have to consider. The American Medical Association clearly outlines a set of guidelines concerning this in sections E-5.026 The Use of Electronic Mail and H-478.997 Guidelines for Patient-Physician Electronic Mail.
Here are 5 best practices for patient email contact found in these guidelines. These will allow you to utilize the benefits of email without the possible risk of malpractice.
Use Email to Supplement Visits
According to a recent study by Brigham and Women’s Hospital, almost 75% of physicians surveyed used email with their patients, but the majority did so with only 1-5% of their patients. It’s important to realize that patient email communication is not for everyone.
- Email should not be used to develop the patient-physician relationship, but only to supplement a pre-existing relationship formed by face-to-face interactions. Offer the email option only to those patients you are familiar with and who you believe would be able to use it properly.
- Never rely on patient email communication with patients you have never treated.
- Don’t rely on electronic communication for interactions or diagnoses that could potentially be emotional for the patient.
Know Legal Constraints
The Health Insurance Portability and Accountability Act passed by congress in 1996 contains new requirements concerning physician-patient confidentiality. The privacy regulations listed help to protect stored information and ensure confidentiality over the Internet.
- Email must operate over a protected server that runs behind a firewall, and sender and receiver must be using encryption technology. Bear in mind, standard email does not adhere to HIPAA guidelines.
- Some sensitive information cannot by law be transmitted to patients electronically. Find a full list of these regulations here.
Be sure your patients are aware of these laws and regulations, and educate them on how to safely communicate over email.
- Physicians: Use clear language, limit the amount of information provided, and encourage questions.
- Patients: They should know who besides the physician processes their messages during vacation or sick days. Instruct patients to put the category of the transaction in the subject line of each email, as well as their name and patient ID number in the message body.
However, no matter what, it is the physician’s job to provide them with information about potential breaches of privacy and confidentiality and give them the opportunity to accept these limitations prior to the communication of privileged information.
Remember AMA: Communication Guidelines
The Communication guidelines presented by the AMA protect privacy and liability concerns for both parties involved. They outline required practices for keeping email communication as secure as possible.
- Establish a turnaround time for all messages sent (for example, 24 to 48 hours)
- Warn the reader of the potentially sensitive subject matter
- Include a standard block of text at the end of each message with your contact info and reminders about security.
- If patients don’t respond after a given amount of time, call them or notify them to come in.
Remember AMA: Administrative Guidelines
The administrative guidelines include information on forming a written letter of consent for the use of patient email communication for physicians. This document should be signed and filed in the patient’s medical record, and include:
- Instructions about when and how to convert to phone calls and office visits if needed
- Description of security mechanisms involved including password-protected screen-savers for all desktop workstations
- A statement holding the health care institution harmless for any information lost due to technical failures
- An agreement to never forward information to a third party without the permission of the patient and never use their email in a marketing scheme
Adopting patient email communication can help your medical office to cut down on the amount of voicemails received and hours spent on the phone. It is estimated that 20% of the 830 million annual office visits per year could be eliminated by online communication, that according to the American College of Physicians. Shrinking the amount of time it takes to schedule and follow-up appointments can help physicians to focus more on providing their patients with the quality healthcare they deserve.