E-mail can be integrated into ophthalmic practice

November 1, 2008

Physicians seem to have grasped the power of the Internet to help them secure continuing medical education credits in a way that precisely meets their professional interests and time constraints.

Key Points

But what about our professional lives? Physicians who rely on their personal digital assistants to stay on schedule and in touch with their families and friends are often not using the Internet to its maximum potential in their practice.

Many physicians report using the Internet to research a specific condition that they have faced in their practice. When using credible sources of information, physicians find that 24-hour access and ease of searching is helpful to getting information to their patients. In fact, they often find that there is too much information available in their search parameters and wading through it all is a challenge.

However, physicians seem to be lagging in their adoption of the Internet as a way to communicate with patients. The reasons for this are likely multi-faceted. No doubt the Health Insurance Portability and Accountability Act and its regulations prompt physicians to worry about the privacy of such transmissions. Others worry about being deluged with responses that come with expectations of prompt replies. Others still are concerned about documenting such exchanges in patient charts or about the potential for the miscommunication that e-mail, which omits nuance and tone from a conversation, inevitably brings.

This is unfortunate, because the Internet offers the opportunity to deliver the information patients want quickly. As a community, physicians need to work to remove some of the barriers to Internet communication-legal, financial, or logistical.

Several years ago, the American Medical Association (AMA) released a statement about physician e-mail, which, in part, stated "new communication technologies must never replace the crucial interpersonal contacts that are the very basis of the patient-physician relationship. Rather, electronic mail and other forms of Internet communication should be used to enhance such contacts."

The AMA statement provided guidelines for physicians to use to improve such communications, several of which are particularly worth repeating:

The AMA document continued, "When communicating with patients via e-mail, physicians should take the same precautions used when sending faxes to patients. These precautions are presented in the following considerations":

There are many reasons to integrate e-mail more heavily into your practice and streamline the time and manner in which you provide information to your patients. Handling general medical and pharmaceutical questions, prescription refill requests, referrals, and appointment scheduling are just a few. Physicians can respond to e-mail messages during non-patient hours instead of letting them interfere with an already-busy clinical schedule.

Remember that e-mail messages from patients do not have to be answered exclusively by the physician. Like phone messages, many of them can be handled by a nurse or other staffer. E-mail also can be printed and stored in the patient's chart.

H. Jay Wisnicki, MD editor of Tech Talk, is director, Department of Ophthalmology, Beth Israel Medical Center, New York. He holds degrees in computer and electrical engineering and has won awards in the application of computers in medicine. He has been an advisor to the American Academy of Ophthalmology in education technology and advises others as well in health-care information technology.