Why Your Doctor Won’t Send You Email

According to the American Health Information Management Association (AHIMA), fewer than 40% of health care providers use the cost-saving conveniences of email to communicate with their patients.

The vast majority of physicians won’t correspond with patients because they’re afraid they’ll:

• be innundated with stupid questions;
• respond too late to an emergency;
• be sued for malpractice;
• be sued for violating privacy laws, and;
• never be reimbursed for services.

Stupid questions, email malpractice and emergency response can be dealt with through a decent patient email agreement.

The University of Washington’s Agreement for Email Correspondence transfers all risks to those patients who insist on using email:

Patients should understand that there are known and unknown risks that may affect the privacy of their personal health care information when using email to communicate. Those risks include, but are not limited, to:

• Email can be forwarded, printed, and stored in numerous paper and electronic forms and be received by many intended and unintended recipients without my knowledge or agreement.
• Email may be sent to the wrong address by any sender or receiver.
• Email is easier to forge than handwritten or signed papers.
• Copies of email may exist even after the sender or the receiver has deleted his or her copy.
• Email service providers have a right to archive and inspect emails sent through their systems.
• Email can be intercepted, altered, forwarded, or used without detection or authorization.
• Email can spread computer viruses.
• Email delivery is not guaranteed.

As most medicos know, legalities are only as binding as a judge sees fit… especially with the long shadow cast over the health business by the Health Insurance Portability and Accountability Act (HIPAA).

Not only has the Act made it really hard to stay out of a courtroom, but health pros are having more and more trouble keeping up with HIPAA’s requirements.

In The State of HIPAA Privacy and Security Compliance [pdf], AHIMA claims that the number of hospitals and health systems who believe they are at least 85% compliant with the privacy and security rules of HIPAA dropped from 91% to 85% in one year.

The drop from 2005 to 2006 is largely attributed to lack of upper management support, expressed primarily through reduced budgets for staff training.

At the same time, over half reported upgrading computer security. The top five upgrades:

In other words, half of the 1100 survey respondents improved security, while the other half didn’t. And that’s at hospitals and health systems.

Imagine a non-system doctor’s office, with less management, less training, and little or no security expertise. What would you do?

Assuming your doc can crawl over the privacy and security hurdles, there’s still the question of reimbursement for the doctor’s services.

Luckily, that can be done the same way a doc has always handled dispensing medical advice over the phone. The nurse sets an appointment.

Nevertheless, there’s still hope. Hand your doctor the reading list that follows, take two aspirin, and email ‘em in the morning.

Email Battles Backgrounder:

• 2006 HIPAA Privacy and Security Survey Results; American Health Information Management Association; April 2006.
• Email consultations in health care: 1–scope and effectiveness; Car and Sheikh; Information in practice; British Medical Journal; 21 August 2004.
• Email consultations in health care: 2–acceptability and safe application; Information in practice; British Medical Journal; 21 August 2004.
• E-mail as a Provider-Patient Electronic Communication Medium and Its Impact on the Electronic Health Record; e-HIM Work Group; American Health Information Management Association; October 2003.
• Internet Health Resources; Susannah Fox and Deborah Fallows; Pew Internet & American Life Project; 16 July 2003.
• How To Communicate With Your Doctor Using Email; Daniel Z. Sands; Healthcare Today.