What To Watch Out For

In its guidelines on physician-patient electronic communications, the American Medical Association emphasizes that e-communications shouldn't replace the "crucial interpersonal contact" that's the basis of the patient-doctor relationship. Email should be used for follow-up care and clarification of advice already provided in an office setting, the association says.

Among the benefits of e-communications, the AMA says, is the fact that it provides written documentation of instructions given to the patient--which for clinicians can be an advantage if they're sued for negligence. The AMA also encourages clinicians to post education handouts on a patient portal.

At the same time, however, the AMA's guidelines offer several warnings:

>> Use caution when communicating about urgent matters.

>> Develop an archival and retrieval mechanism.

>> Avoid sending a group message that reveals patients' email addresses.

>> Don't use patients' email addresses for marketing purposes.

>> Provide automatic replies that let patients know clinicians have received their messages.

>> Use encryption for wireless communications.

>> Put an informed consent agreement in place.

>> Make sure workstations used for patient communications are password protected.

An American College of Physicians' position paper, "E-Health And Its Impact On Medical Practice," takes a more positive stance on such doctor-patient communications, with statements such as "e-health activities have the potential to transform the healthcare delivery system." It also discusses the value of e-tools to help "advance the patient-centered" model of home care. But the ACP isn't all positive. It also has concerns about the legal ramifications of e-communications.