Electronic health communication:
Communication processes in health care have undergone dramatic changes through use of electronic means of communication. Patients have increased access to health information on Internet sites even though they may lack the ability to judge the quality of the information obtained. Health care providers have access to information through online reference materials and clinical practice guidelines.
Clinicians can access patient records and lab test results as well as place orders electronically in health systems with integrated electronic medical records. Providers can communicate directly with patients and provide individualized patient care through e-mail consultations. Finally, providers can consult with other health professionals who are caring for a patient or can seek “specialty” consults through use of electronic communication.
Aim:
1. Provide the background information to understand current use of the Internet, and most specifically e-mail, in health care,
2. Describe issues related to use of electronic communication in patient–provider relationships,
3.Describe inter-professional consultations and other uses of communication technology,
4. Discuss the security and privacy issues involved in use of e-mail in patient care,
5.Describe patient consent procedures needed in establishing pharmaceutical care services using e-mail communication,
6. Describe the challenge of composing e-mails that are clear, concise, complete, credible, and courteous, and
7. Describe techniques for managing e-mail exchanges.
AN E-MAIL HEALTH CARE STORY
Mr. Samuels flies across the country to start a new job. He has already chosen a medical practice in his new town because it has the same online health support service as his previous doctor, even though it is a different medical plan.
He can set up appointments, get prescription refills and lab results, e-mail the doctor or nurses, and manage his personal health history. He develops fever and muscle aches a week after he arrives. Fearing that he may have anthrax or smallpox, he e-mails his new doctor a list of his symptoms, along with his itinerary over the previous 14 days.
The doctor’s automatic system immediately matches his itinerary against the public health database of anthrax and smallpox occurrences and runs his symptoms against his own personal health record, including his medications. It sends an urgent alert to the doctor, who sees no likely source of exposure for Mr. Samuels but spots a potential drug–drug interaction. She calls him and tells him that the new drug he just started could have caused an adverse reaction. She feels confident that he does not need to come in for tests or take unnecessary antibiotics. Instead, she changes his medication and asks him to e-mail her in 24 hours. The next day, his e-mail message confirms that his fever and aches are gone. Unnecessary lab tests, investigation by public health authorities, anxiety for Mr. Samuels and his family, and an unneeded antibiotic are all avoided. This “nonevent” is the happiest of all endings for Mr. Samuels, his doctor, and the health of the public.
Mr. Samuels lives in “The Interactive Communication Age.” The rise of consumerism and patient empowerment has created a set of expectations based on a rapid, relentless societal pace and increased need for information. The consumer (patient) expects the best price along with personal control, choice, and convenience.
When people in today’s society ask for something, they want “understandable, appropriate responses and do-able actions” when, where, and how they choose. One way they get immediate access to information is by using the Internet.