Doctors who are using e-mail with their patients: a qualitative exploration.
BACKGROUND
Despite the potential for rapid, asynchronous, documentable communication, the use of e-mail for physician-patient communication has not been widely adopted.


OBJECTIVE
To survey physicians currently using e-mail with their patients daily to understand their experiences.


METHODS
In-depth phone interviews of 45 physicians currently using e-mail with patients were audio taped and transcribed verbatim. Two investigators independently qualitatively coded comments. Differences were adjudicated by group consensus.


RESULTS
Almost all of the 642 comments from these physicians who currently use e-mail with patients daily could be grouped into 1 of 4 broad domains: (1) e-mail access and content, (2) effects of e-mail on the doctor-patient relationship, (3) managing clinical issues by e-mail, and (4) integrating e-mail into office processes. The most consistent theme was that e-mail communication enhances chronic-disease management. Many physicians also reported improved continuity of care and increased flexibility in responding to nonurgent issues. Integration of e-mail into daily workflow, such as utilization of office personnel, appears to be a significant area of concern for many of the physicians. For other issues, such as content, efficiency of e-mail, and confidentiality, there were diverging experiences and opinions. Physicians appear to be selective in choosing which patients they will communicate with via e-mail, but the criteria for selection is unclear.


CONCLUSIONS
These physician respondents did perceive benefits to e-mail with a select group of patients. Several areas, such as identifying clinical situations where e-mail communication is effective, incorporating e-mail into office flow, and being reimbursed for online medical care/communication, need to be addressed before this mode of communication diffuses into most practices.
Patt
Madhavi R
MR
Johns Hopkins University, Baltimore, MD, USA.
Houston
Thomas K
TK
Jenckes
Mollie W
MW
Sands
Daniel Z
DZ
Ford
Daniel E
DE
D000328:Adult; D003625:Data Collection; D034742:Electronic Mail / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000639:trends*; D008875:Middle Aged; D009817:Office Management / Q000639:trends; D010817:Physician-Patient Relations; D010820:Physicians / Q000639:trends*