title: Patient, staff, and clinician perspectives on implementing electronic communications in an interdisciplinary rural family health practice.
abstract: Aim To conduct an environmental scan of a rural primary care clinic to assess the feasibility of implementing an e-communications system between patients and clinic staff.
  
  
  
  Increasing demands on healthcare require greater efficiencies in communications and services, particularly in rural areas. E-communications may improve clinic efficiency and delivery of healthcare but raises concerns about patient privacy and data security.
  
  
  
  We conducted an environmental scan at one family health team clinic, a high-volume interdisciplinary primary care practice in rural southwestern Ontario, Canada, to determine the feasibility of implementing an e-communications system between its patients and staff. A total of 28 qualitative interviews were conducted (with six physicians, four phone nurses, four physicians' nurses, five receptionists, one business office attendant, five patients, and three pharmacists who provide care to the clinic's patients) along with quantitative surveys of 131 clinic patients. Findings Patients reported using the internet regularly for multiple purposes. Patients indicated they would use email to communicate with their family doctor for prescription refills (65% of respondents), appointment booking (63%), obtaining lab results (60%), and education (50%). Clinic staff expressed concerns about patient confidentiality and data security, the timeliness, complexity and responsibility of responses, and increased workload.
  
  
  
  Clinic staff members are willing to use an e-communications system but clear guidelines are needed for successful adoption and to maintain privacy of patient health data. E-communications might improve access to and quality of care in rural primary care practices.
authors.affiliation: 1School of Pharmacy,University of Waterloo,Waterloo,Ontario,Canada.
authors.forename: Feng
authors.initials: F
authors.lastname: Chang
authors.affiliation: 2School of Public Health and Health Systems, University of Waterloo,Waterloo,Ontario,Canada.
authors.forename: Thivaher
authors.initials: T
authors.lastname: Paramsothy
authors.affiliation: 2School of Public Health and Health Systems, University of Waterloo,Waterloo,Ontario,Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Roche
authors.affiliation: 1School of Pharmacy,University of Waterloo,Waterloo,Ontario,Canada.
authors.forename: Nishi S
authors.initials: NS
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003142:Communication; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology*; D009864:Ontario; D057240:Patient Preference / Q000523:psychology*; D010821:Physicians, Family / Q000523:psychology*; D011320:Primary Health Care / Q000379:methods; D019035:Rural Health Services / Q000458:organization & administration; D017216:Telemedicine / Q000379:methods*
keywords: electronic communications; family practice; outpatient health services; patient survey; qualitative interview; rural primary care