title: Internet use and e-mail communications between patients and providers: a survey of rheumatology outpatients.
abstract: BACKGROUND
  As health care costs rise in the United States and elsewhere, adopting health information technology is being advocated to reduce costs and improve efficiency.
  
  
  METHODS
  Physician e-mail communication is a frequently proposed tool in this strategy.
  
  
  OBJECTIVE
  We examined the interest of rheumatology outpatients in using E-mail for communication with their rheumatologist. We sought to identify their privacy and cost concerns on this issue, and examine the patients' demographics, internet usage, and preferences.
  
  
  METHODS
  An anonymous survey was given to 150 consecutive patients. Patients responded to questions on demographics, rheumatic diseases, comorbidities, computer/internet access, E-mail use, privacy concerns, payment issues, and preferences regarding communication with their rheumatologist. Statistical analyses on the relationships between demographics and patient preferences on communications with their rheumatologist were conducted.
  
  
  RESULTS
  There were 145 respondents; the mean age was 52.3 years, mean education level was 13.6 years. The sample tended to be women (74%), retired/disabled (46%) or employed full time (35%). Most had internet access (74.5%). Differences were found based on gender, age, education, and income levels. Younger adults were more likely to desire E-mail communication with their rheumatologists, especially if paid by insurance. More men than women had concerns about privacy; persons with higher income levels were more willing to self-pay for E-mail.
  
  
  CONCLUSIONS
  As a significant number of patients with rheumatic diseases express interest in E-mail communication with their providers, rheumatologists need to be cognizant of patients' preferences. To deliver patient-centered care, rheumatology practices might consider incorporating E-mail communication into their practices.
authors.affiliation: Division of Immunology and Rheumatology, School of Medicine, University of Missouri-Columbia, Columbia, MO 65212, USA. sivac@health.missouri.edu
authors.forename: Chokkalingam
authors.initials: C
authors.lastname: Siva
authors.forename: Karen L
authors.initials: KL
authors.lastname: Smarr
authors.forename: Kathleen Donovan
authors.initials: KD
authors.lastname: Hanson
authors.forename: Meghal
authors.initials: M
authors.lastname: Parikh
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lawlor
authors.forename: Bin
authors.initials: B
authors.lastname: Ge
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003142:Communication; D003219:Confidentiality; D003625:Data Collection; D004522:Educational Status; D034742:Electronic Mail; D005260:Female; D017048:Health Care Costs; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D008923:Missouri; D010045:Outpatients; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000379:methods / Q000639:trends*; D010817:Physician-Patient Relations; D012219:Rheumatology / Q000706:statistics & numerical data*; D012737:Sex Factors; D012923:Social Class; D011795:Surveys and Questionnaires