title: Email communication at the medical primary-secondary care interface: a qualitative exploration.
abstract: BACKGROUND
  There is little published research into the influence of email communication between primary and secondary care clinicians on patient care.
  
  
  OBJECTIVE
  To explore the use of email communication between clinicians across the primary- secondary care interface, and how this may relate to patient care.
  
  
  METHODS
  A qualitative study involving primary and secondary care services in the NHS Highland Health Board area, Scotland. Ten GPs and 12 hospital consultants were purposively sampled to reflect diversity.
  
  
  METHODS
  Eligible clinicians were invited to take part in a semi-structured interview. Data were analysed using a thematic analysis approach.
  
  
  RESULTS
  Key themes that emerged for clinicians included general perceptions of email; using email in practice (managing workload, impact on patient journeys, and 'quick answers'); system issues (variability and governance); relational aspects; and email skills.
  
  
  CONCLUSIONS
  Email communication between primary and secondary care clinicians generally has a positive impact on patient access to specialist expertise. Governance issues around the use of clinical email need to be defined. There may currently be a two-tier health service for those patients (and their GPs) requiring 'quick answers'.
authors.forename: Rod
authors.initials: R
authors.lastname: Sampson
authors.forename: Rosaline
authors.initials: R
authors.lastname: Barbour
authors.forename: Philip
authors.initials: P
authors.lastname: Wilson
mesh_terms: D001291:Attitude of Health Personnel; D034742:Electronic Mail; D006801:Humans; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration; D011446:Prospective Studies; D036301:Qualitative Research; D012017:Referral and Consultation / Q000458:organization & administration*; D012606:Scotland; D063127:Secondary Health Care / Q000458:organization & administration
keywords: email; interface; patient care; primary health care; relationship; secondary care