title: Perceived Barriers to and Facilitators of Patient-to-Provider E-Mail in the Management of Diabetes Care.
abstract: OBJECTIVE
  1) to describe current utilization of e-mail in the clinical care of patients with diabetes; and 2) to identify barriers to and facilitators of the adoption of e-mail in diabetes care.
  
  
  METHODS
  Participants included diabetes care providers, including 9 physicians and 7 allied health professionals (AHPs). Participation involved, first, completing a self-administered survey to evaluate the use of e-mail within diabetes-related clinical practice. Second, focus group discussions were conducted with diabetes care providers using semistructured interviews to collect data about their perceptions of using e-mail to exchange information with patients diagnosed with diabetes. Patients' perspectives on the use of e-communication with their care providers was also proposed on the basis of the discussions.
  
  
  RESULTS
  Significant differences were found between physicians and AHPs concerning questions that were related to the use of e-mail and the amount of time spent using e-mail to communicate to patients. There was perceived function and value to the use of e-mail among AHPs, while few physicians used e-mail routinely and were uncertain about its potential in improving care. Five themes, including barriers, benefits, risks, safeguards and compensation, were developed from the focus group interviews.
  
  
  CONCLUSIONS
  Currently, most of the physicians surveyed do not e-mail patients directly; however, AHPs frequently use e-mail in diabetes care and find this tool valuable. Variation in practices regarding clinical e-mail across care disciplines suggest that appropriate policy with guidelines for e-mail and e-communication within the health care system may improve uptake of clinical e-mail and perhaps, by extension, improve efficiency and access in diabetes care.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Naomi
authors.initials: N
authors.lastname: Popeski
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Caitlin
authors.initials: C
authors.lastname: McKeen
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Bushra
authors.initials: B
authors.lastname: Khokhar
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alun
authors.initials: A
authors.lastname: Edwards
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: William A
authors.initials: WA
authors.lastname: Ghali
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Sargious
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Debbie
authors.initials: D
authors.lastname: White
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Marilynne
authors.initials: M
authors.lastname: Hebert
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: Doreen.Rabi@albertahealthservices.ca.
authors.forename: Doreen M
authors.initials: DM
authors.lastname: Rabi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003142:Communication; D003920:Diabetes Mellitus / Q000517:prevention & control*; D019468:Disease Management; D034742:Electronic Mail / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011320:Primary Health Care; D019114:Remote Consultation; D011795:Surveys and Questionnaires
keywords: barriers; communication électronique; electronic communication; facilitateurs; facilitators; focus group; groupe de discussion; obstacles