title: Experiences of patients who were early adopters of electronic communication with their physician: satisfaction, benefits, and concerns.
abstract: OBJECTIVE
  To explore the experiences of patients who were early adopters of e-mail communication with their physicians.
  
  
  METHODS
  Patients' experiences were assessed with an Internetbased survey of 1881 individuals and in-depth telephone follow-up interviews with 56 individuals who used e-mail to communicate with providers. Two investigators qualitatively coded interview comments independently, with differences adjudicated by group consensus.
  
  
  RESULTS
  A total of 311 (16.5%) of the 1881 individuals reported using electronic mail to communicate with their physicians. Compared with the population-based Behavioral Risk Factor Surveillance Survey, users of e-mail with physicians were twice as likely to have a college education, were younger, were less frequently ethnic minorities, and more frequently reported fair/poor health. Among the 311 patients who used e-mail with their physicians, the most frequent topics were results of laboratory testing and prescription renewals. However, many of the 311 users (21%) also reported using asynchronous e-mail inappropriately to convey urgent or sensitive issues (suicidality, chest pain, etc). Almost all (95%) perceived that e-mail was more efficient than the telephone. Important benefits uncovered from the interviews were that some patients felt more emboldened to ask questions in e-mail compared with face-to-face communication with doctors, and liked the ability to save the e-mail messages. Users also expressed concerns about privacy.
  
  
  CONCLUSIONS
  Patients that use electronic communication with their physicians find the communication efficient for disease management. Further patient education about inappropriate use of e-mail for urgent issues is needed.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Ala 35294, USA. tkhouston@uabmc.edu
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Houston
authors.forename: Daniel Z
authors.initials: DZ
authors.lastname: Sands
authors.forename: Mollie W
authors.initials: MW
authors.lastname: Jenckes
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Ford
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection; D034742:Electronic Mail / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D014481:United States