Physician-Patient Communication Changed by Electronic Mail Exchange - Annotated Bibliography Example

 Patient communications; 4500 physicians to offer email with patients. (2003). Health & Medicine Week, , 46-46. Retrieved from http://ezproxy.snhu.edu/login?url=http://search.proquest.com/docview/206812110?accountid=3783 Medem agreed to provide secure communications such as online consultation and prescription renewal through online physician websites. Using email as a communication medium allows greater flexibility to patients and many times faster response. This is also believed to save patients money and time while reducing liability risk of physicians in Oklahoma and Texas. Kittler, A. F., Carlson, G. L., Harris, C., Lippincott, M., Pizziferri, L., Volk, L. A., & ... Bates, D. W. (2004). Primary care physician attitudes towards using a secure web-based portal designed to facilitate electronic communication with patients. Informatics In Primary Care, 12(3), 129-138. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&hid=3&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 It was estimated in 2004 that 64% of physician’s use email in their communications with staff, patients, colleagues and third party payers. This study found that patients are often frustrated and upset with the difficulty they encounter when trying to reach a physician by telephone hence the increase in patients requesting physicians to use email as a communication method. Benefits for physicians allow them to respond at any time and at their convenience while also allowing templates to be provided that respond to certain questions regarding care. Patient Gateway was used as a pilot program in certain ambulatory clinics. Results indicated that physicians felt the program was a positive though limitations of the study were that physicians were not yet using direct general messaging and the sample size was relatively small. Kummervold, P., & Johnsen, J. K. (2011). Physician Response Time When Communicating With Patients Over the Internet. Journal Of Medical Internet Research, 13(4), 37. doi:10.2196/jmir.1583 Retrieved from http://ehis.ebscohost.com/eds/detail?vid=7&hid=121&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=lih&AN=70445911 The majority of the European populations use the internet for health reasons; only 10% communicate with their physician this way. Two distinct suppliers of internet secure patient communication systems supplied a list of those offices that were currently using their system and of those offices 9 participated in this study. The study lasted for one year, logging over 1300 messages. The length of the patient’s questions predicted physician’s time spent answering. One of the most distinctive reasons physicians are skeptical about using electronic communication was the potential for an increase in workload. Results of this study show that these concerns were unfounded and workloads were not necessarily increased. Limitations of this study were that all physicians were Norwegian rather than random. The study concludes that email communication can be used in patient centered communication having benefits on both parties. Kleiner, K. D., Akers, R., Burke, B. L., & Werner, E. J. (2002). Parent and Physician Attitudes Regarding Electronic Communication in Pediatric Practices. Pediatrics, 109(5), 740 Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&hid=103&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 The objective of this study was to determine if families, pediatricians, and specialist pediatricians were capable of using email based systems to provide treatment and electronic based communication. 325 parents and 37 physicians participated and methodology used was interview questions and surveys. Two surveys were used; one for physicians and one for parents. Over 70% of families showed an interest in using email to schedule appointments, get prescription refills, ask questions and obtain test results. Parents at specialty pediatrician offices expressed greater concern over the privacy of their electronic transmissions then did the parents at general Pediatricians offices. 70% of physicians believed that email should be used to schedule appointments while only 20% thought email was an appropriate medium to deliver test results. This is understandable as many test results are of a sensitive nature that must be handled with some compassion and also backed by knowledge which empowers the patient. Legal factors will likely play a big part in the future of email communications due to the consideration of malpractice suits. Gaster, B., Knight, C. L., DeWitt, D. E., Sheffield, J. L., Assefi, N. P., & Buchwald, D. (2003). Physicians' Use of and Attitudes Toward Electronic Mail for Patient Communication. JGIM: Journal Of General Internal Medicine, 18(5), 385-389. doi:10.1046/j.1525-1497.2003.20627.x Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&hid=103&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 This study was completed in 2001, spanning the course of a year and used the database that was maintained by the University of Washington to track all physicians who care for patients in an outpatient clinic setting and their use of email, electronic medical records and office computers. A questionnaire was designed based on national guidelines for the use of email with patients in clinical practice. 249 physicians completed surveys and indicated that 72% used email communications with patients. More than half of the physicians stated they rarely document this communication in patient records. It was agreed that appointment scheduling was most appropriate for email use with disease management and questions regarding new symptoms inappropriate for email communications. Confidentiality was the primary concern. Emails received monthly did not make up a substantial portion of patient communication. Virji, A., Yarnall, K., Krause, K., Pollak, K., Scannell, M., Gradison, M., & Østbye, T. (2006). Use of email in a family practice setting: opportunities and challenges in patient- and physician-initiated communication. BMC Medicine, 418-7. doi:10.1186/1741-7015-4-18 Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&hid=115&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 Two studies were conducted in a family practice setting using an anonymous survey to determine how many patients were receptive to email communications with physicians and a random controlled pilot program to evaluate the feasibility of communicating health information via email. 80% of the patients were interested in using email communications with physicians and 42% were willing to pay a fee for this convenience. The study concluded that lower income patients provide an ethical dilemma for physician’s who institute email communication methods. Pickert, K. (2010). The Doctor Is in--and Online. Time, 176(6), 48. Retrieved from http://ehis.ebscohost.com/eds/detail?vid=7&hid=114&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=aph&AN=52621846 Electronic communication is not a billable item by Medicare or Medicaid or most insurers. The Patient Protection and Affordable Care Act may help propagate the use of email, funding systems similar to Kaiser, which uses email communication with diabetic patients on helping them to manage blood sugar levels better. Though more Doctors are starting to communicate with patients in conversation form via email most are not simply because they are not reimbursed for this practice and there are liability issues to be considered. Some insurers such as Cigna pay 25.00 for ‘e-visits’ while in person visits are billed at 50-100 per hour. Kuchka-Craig, D. (2010). the next frontier: Yellow lollipops. That's what I remember most clearly. Hfm (Healthcare Financial Management), 64(12), 26. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&hid=114&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 Seattle based company Group Health Cooperative currently use an email system of interaction and care and indicate that patient satisfaction as well as loyalty have been increased along with the volume of email. Costs have also gone down with the decrease of staff members who previously spent most of their time on the phone. All of their physicians are salaried which removes the barrier of payment methods. Tjora, A., Tran, T., & Faxvaag, A. (2005). Privacy vs Usability: A Qualitative Exploration of Patients' Experiences With Secure Internet Communication With Their General Practitioner. Journal Of Medical Internet Research, 7(2), N.PAG. doi:10.2196/jmir.7.2.e15 Retrieved from http://ehis.ebscohost.com/eds/detail?vid=7&hid=114&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=lih&AN=19353720 This research studied the patient experiences that were using secure electronic communication systems and measured against the usability of these systems. Interviews were qualitative with 15 patients and there were six main themes identified; security issues, different aspects of written communication, support for simple inquiries, the physicians trustworthiness, the ease of use of MedAxess (the system), and trouble using the system. Though the patients felt the system was secure because of this very reason log in was discouraging. Security barriers in place also had the effect of making use difficult for the average patient. Over half of the participants felt the physician responded quickly when they were able to use the system successfully. Paris, J. J. (2001). Ethical Issues in Cybermedicine. America, 184(4), 15. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&hid=3&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 One website, CyberDocs.com will provide you with a physician’s care for a fee ranging from 50-100.00. These virtual appointments treat minor ailments and physicians can prescribe all medications except for controlled substances such as narcotics. The site receives over 10,000 visits per day and obviously fills a need for a segment of the population. Email access to a physician along with pharmacy services. For drugs such as Viagra many sites do not require a prescription and instead offer an online questionnaire before providing the medication anonymously. Many sites require no evaluation at all. It is clear these sites are less secure and more at risk for liability issues though many are based out of the Country. It is recommended by the American Medical Council that under no circumstances should medication be prescribed without a face to face evaluation for health and safety reason. This use of electronic communication between physicians and patients goes beyond what is considered ethical and is becoming more commonplace. Off shore medical sites provide medications and services that cannot be controlled similar to offshore banking institutions. The prevalence of this unethical use of virtual communication makes legitimate practices weary of this type of service. Capko, J., & Capko, J. (2011). Not e-mailing patients? Here's why you should be. Urology Times, 39(10), 50-52. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&hid=2&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 Though many physicians today use email as a form of communication Urologists have been hesitant; they are concerned with being inundated with a large volume of mail taking time away from their practice as well as liability from potential misunderstandings. They are also concerned with provided unreimbursed services. Establishing clear boundaries up front can alleviate some of these concerns. Some insurers are beginning to pay providers for email services due to the efficiency and cost saving nature of this form of communication for simple matters such as questions regarding drug interactions. Those that are eligible for reimbursement must comply with current HIPAA standards. McKillen, D. (2001). PHYSICIAN - PATIENT ONLINE COMMUNICATIONS. Medical Marketing & Media, 36(11), 12. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=8&hid=2&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15 Patient’s todays want quicker and more convenient ways to contact their physicians. Physicians also prefer to free up their staff to handle other issues aside from fielding phone calls all day. One specialized service, MDHUB, has created thousands of web pages for physicians in order to allow them the ability to communicate electronically with patients and provide online services such as appointment setting, refills, referrals and simple questions. Medem has a very secure framework which makes it impossible for transmissions to be intercepted where users must login and have a password in order to decrypt sent messages. Though it is likely to take several more years it is expected that more physicians will integrate this into their practice. Manhattan, R. (0005, April). 75% of U.S. Physicians Own Some Form of Apple Device According to New Manhattan Research Study. Business Wire (English). Retrieved from http://ehis.ebscohost.com/eds/detail?vid=8&hid=2&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=bwh&AN=bizwire.c33841904 Over 75% of physicians use some form of Apple communication device, many to access medical records. Despite the popularity of the Iphone Physicians have been flocking to the Ipad and electronic records access seems to be a deciding factors in many physicians decisions. This trend is expected to continue as capabilities expand. New applications releases that assist physicians in electronic communication and access include ePharma Physician and Digital Medtech. Studies have not been completed though they are in progress concerning the efficiency and usability of these applications. Medsoft. (7). Medsoft Delivers Groundbreaking Hospital Rounding Solution for Barrow Neurological Institute. Business Wire (English). Retrieved from http://ehis.ebscohost.com/eds/detail?vid=8&hid=114&sid=8db7aa26-4efb-4c76-9dbd-86dc198f44ca%40sessionmgr15&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=bwh&AN=bizwire.c35607879oftware Medsoft, a producer of medical established a partnership with Barrow Neurological Institute’s Department of Neurology Residency Program in order to create a customized version of the software HybridChart. This software allows you to combine electronic tools with communication capabilities and is expected to simplify rounds. Using an electronic medium of communication can save time when giving report as well as ensure critical data is recorded immediately and not forgotten during the reporting phase of changing residents. It is reported that this software is easy to use while also being secure; a benefit many secure software suites do not share. Read More