Physician email implementation inertia

by Jon Meyer

Looking at the industry response to the recent study released by the Center for Studying Health System Change, Physicians Slow to E-mail Routinely with Patients – Issue Brief No. 134, it appears that a piece of the puzzle is missing. Both the study, and the analysis, put the physician at the center of the email debate. In reality, about 30% of a medical practice’s communication is from the doctor.

The comment that, “only 6.7 percent of office-based physicians routinely emailed patients in 2008” should not become the headline, or even the summary.

The key statement should read, “HIPAA compliant secure email statistically improves healthcare, saves overhead expenses due to efficiencies, and responds to the requirements of legislated healthcare reform.”

It may be that the physician is responding to a survey question that is not properly structured.  The analysis postulates that physicians assumed each is individually communicating with patients, peers, and business associates.

When examining a practice’s existing workflow, analysis indicates that it is the staff who will best benefit from secure electronic mail. A physician’s role is not to take time for routine communications, but rather to oversee the quality of patient health.

Rather than simply looking at email for personal use, the physician might better view encrypted email as a tool that can improve care, save labor costs, and improve job satisfaction by allowing the staff to communicate asynchronously.

Think about the last time you visited a doctor’s office. The staff were each on the phone, writing notes, filing information, or responding to patient questions. MaxMD’s survey of their encrypted email users indicates that some 70 percent of secure electronic communications are initiated by office staff, not by the physician themselves.

Patients might be given an office identity email address (i.e. [email protected]), which internally is recognized as a general office account. The physician’s personal address should be restricted and may take the form of [email protected]. This is similar to other industries. The individual will not need to answer a flood of messages arriving on the Blackberry or other smartphone.

Developing efficiencies is simply a matter of applying some of the standard operating procedures employed by today’s business leaders. Selective use of email accounts facilitates good communication while reducing disruption.

Outside of the healthcare profession, every other industry has found major improvements with electronic communication. Current reports indicate that the US Postal Service expects a $6 Billion operating loss this year. The chief competitor is email.

Each person involved with the coordination and administration of medical care should be sensitive to patient needs and reaction time. Secure email for healthcare professionals is a higher priority need for office staff than it is for individual physicians.

When you consider that some 85% of healthcare practices have flat to declining revenue over the past three years ( the physician foundation study) it only makes sense to look at encrypted email as other industries have. Email is ubiquitous because it is a valuable business tool.

Electronic communication is not simply a cost savings measure. It is truly a better tool for building patient ownership in medical care participation.

In a Kaiser study of 35,423 people with diabetes, hypertension, or both, the use of secure email over the course of a two-month period was associated with a statistically significant improvement in effectiveness of care. Researchers found a 2.0–6.5 percentage point performance improvement, based on Healthcare Effectiveness Data and Information Set (HEDIS) measures such as glycemic (HbA1c), cholesterol, and blood pressure screening.

Compound this data with other recent  findings printed in, The Annals of Family Medicine which estimated, “health care costs would likely decrease by 5.6%, resulting in national savings of 67 billion dollars per year”, based on simply communicating patient health information between professionals on an improved basis.

Rather than discussing the inertia of physician email, we should be looking at supporting every other piece of the communications puzzle including EMR / EHR document, Continuity of Care Data, Health Information Exchanges, Clinical Data Repositories and Patient Response.

HIPAA compliant secure email statistically improves healthcare, saves overhead expenses due to efficiencies, and responds to the requirements of legislated healthcare reform.

Jon Meyer represents MaxMD.

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