E-mail Communication with Patients

E-mail is fast surpassing not only traditional “snail” mail, but the telephone, as a means of communication.Estimates of email users and email accounts world-wide are in the range of 1.3-1.4 billion. All the reasons that make e-mail a great tool for general communications, such as speed, efficiency, and clarity, also make it a useful tool for practitioners. 


Estimates are that one-third of US physicians either e-mail or text message with patients.  Patients also want to use email with their health care providers, a fact verified by a 2007 study out of the University of Pittsburgh, which monitored use of emails between pediatricians and the parents of their patients.[1]  In the study patients were offered the opportunity to agree to participate in email communications with the providers.  Of the 328 families who were offered the service, 306 enrolled, and 121 actually used the service during the study period.  The families who responded to a follow-up survey agreed that the use of email increased access to the physician and improved quality of care. 


By now you have likely heard the familiar refrain at Trust lectures about the risks inherent in communicating sensitive information by email, and the fact that the majority of the time email will be discoverable in civil litigation.  This stems from the fact that, unlike a phone call, e-mail is the equivalent of a recorded conversation and is permanent.  These risks are highlighted when the email communication at issue is between a practitioner and her patient.  In the event of a malpractice suit, any email statements from a physician to a patient would not only be discoverable, but could also come into evidence at trial.


As email inquiries and requests from your patients start to grow, it is a good idea to keep in mind some practical pointers to avoid creating a problem for yourself with your e-mail communications with patients:

·        Do not make diagnoses over e-mail; remind the patient that she will need to be seen and examined before you can make a diagnosis.

·        Do not use medical shorthand (e.g., acronyms, abbreviations), because it can be mistyped or misinterpreted.

·        Always remind the patient to go to the ED for urgent issues.

·        For non-patient contacts, include a disclaimer that you are not establishing a physician-patient relationship by responding to their email.

·        Make sure to  keep a copies of all patient  emails you send or receive in  patient charts.


Patient privacy concerns also abound with email.  UVA  has guidelines published to help with HIPAA issues to make sure you are compliant: Email Guidelines. Key provisions of this policy are:

·        Written consent to use email

·        No guarantee of confidentiality

·        Form for the patient to sign indicating their consent and understanding that confidentiality cannot be guaranteed


In sum, for all of its conveniences, you need to be aware of the risks email

creates.  Follow the guidelines and be judicious in your comments, and e-mail can likely be a useful tool for you and your patients. 


            Please contact Bruce Gehle (bdg5qr@virgina.edu) at the Trust if you have any further questions.





[1] Rosen, P, et al. Patient-Physician E-mail: An Opportunity to Transform Pediatric Health Care Delivery, 120 Pediatrics 701 (Oct. 2007).