The role of primary care non-physician clinic staff in e-mail communication with patients

• Published in: International journal of medical informatics (Shannon, Ireland) Ireland), 2004-05, Vol.73 (4), p.333-340
• Main Authors: Kittler, A.F, Wald, J.S, Volk, L.A, Pizziferri, L, Jagannath, Y, Harris, C, Lippincott, M, Yu, T, Hobbs, J, Bates, D.W
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Boston; Communication; Data Collection; Electronic Mail; Female; Healthcare quality; Humans; Male; Middle Aged; Physician-Patient Relations; Practice Management, Medical - organization & administration; Primary Health Care - organization & administration; Professional Role; Safety; Satisfaction; Staff attitude; Staff workload; United States
• ISSN: 1386-5056; 1872-8243
• DOI: 10.1016/j.ijmedinf.2004.02.004

Background: Few studies have explicitly addressed how e-mail technology may affect non-physician clinic staff, even though these staff typically manage tasks well suited to e-mail communication such as requests for prescription renewals, laboratory and test results, and referral authorizations. Goal: We conducted a survey of staff members at 10 primary care clinics in Boston to further evaluate non-physician staff attitudes towards e-mail use with patients. We subsequently re-surveyed staff at three of these clinics after the implementation of Patient Gateway, an application designed to facilitate secure electronic communication between patients and the clinics. Results: Before Patient Gateway implementation, 88% of surveyed staff were already using e-mail at least once a day for work-related communication. Many of these staff members (24%) were already using e-mail with patients. Forty-eight percent of staff members thought that increasing e-mail use with patients could improve the quality of care their practices delivered. However, staff reported having some hesitations about increasing e-mail use with patients, mostly relating to security, confidentiality, and workload. After Patient Gateway implementation, users reported high satisfaction with the application and staff in general (users and non-users of Patient Gateway) felt more enthusiastic about increasing e-mail use with patients. Conclusions: In order to maximize the potential of staff–patient e-mail, it is important that concerns relating to security, confidentiality, and workflow are addressed, and patients must be given guidelines for the appropriate use of e-mail. Secure applications designed with these issues in mind are likely to be well received by staff members, and in turn physicians.