title: Primary care physician attitudes towards using a secure web-based portal designed to facilitate electronic communication with patients.
abstract: BACKGROUND
  Patient demand for email contact with physician practices is high. If physicians met this demand, improvements in communication, quality of care and patient satisfaction could result. However, physicians have typically been hesitant to communicate electronically with patients, largely due to concerns relating to workload, security and lack of compensation.
  
  
  OBJECTIVE
  To assess physician attitudes towards electronic communication with patients six months after the implementation of an application called Patient Gateway. Patient Gateway allows patients to access an extract of their medical record and facilitates online communication with medical practices.
  
  
  METHODS
  A paper-based survey was administered to the 43 primary care physicians in one integrated delivery system, with a 56% (24/43) response rate.
  
  
  RESULTS
  Overall, physicians felt that Patient Gateway's impact on their practices was positive, especially in the areas of refill and referral request management and appointment scheduling. However, physicians are still hesitant to increase general electronic communication with patients; none opted to use Patient Gateway's general messaging function with patients, and those who had previously used outside systems to exchange emails with some patients continued to communicate with only a small proportion of their patient panel in this way. However, 38% of physicians already communicate with their own physicians via email, and another 19% would like to do so.
  
  
  CONCLUSIONS
  Physicians' fears about being overwhelmed with messages were not realised. While physicians were generally enthusiastic about the application, none used it directly to communicate with patients. Over three-quarters of respondents indicated that they would be more enthusiastic about electronic communication with patients if this time were compensated.
authors.affiliation: Department of Clinical and Quality Analysis, Information Systems, Partners HealthCare System, Boston, Massachusetts, USA.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Kittler
authors.forename: Ginny L
authors.initials: GL
authors.lastname: Carlson
authors.forename: Cathyann
authors.initials: C
authors.lastname: Harris
authors.forename: Margaret
authors.initials: M
authors.lastname: Lippincott
authors.forename: Lisa
authors.initials: L
authors.lastname: Pizziferri
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Volk
authors.forename: Yamini
authors.initials: Y
authors.lastname: Jagannath
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Wald
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D034742:Electronic Mail; D005260:Female; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011795:Surveys and Questionnaires