”Email is the killer app of patient portals.”
I heard a variation of that quote when interviewing people for the patient-provider communication chapter of the book I’ve been co-editing and writing for HIMSS with Jan Oldenburg, Brad Tritle and Kate Christensen. For the organizations who’ve pushed patient portals the furthest into their patient base, email is always the place where things started. In other words, email is the gateway drug for patient engagement which Leonard Kish called the blockbuster “drug” of the century.
Physicians are understandably concerned about being overwhelmed by emails if they provide an option for secure messaging. As healthcare transforms, financial incentives have a big effect on the willingness to take on what many perceive to be “more unpaid work” (forgetting the fact that playing voicemail tag is also unpaid). Interestingly, the physicians who have given out their phone number or enabled secure email (without remuneration) haven’t found they are overwhelmed by any means. In the case of the groundbreaking Open Notes study, many of the doctors just heard crickets. For those who have proactively enabled email communications, they have experienced a number of benefits. See the section below on improvements in outcomes simply by having email. [Disclosure: One of the capabilities included in the patient relationship management system my company provides is secure email.]
Dr. Ted Epperly has been a family doctor for decades and describes his experience as follows:
“I give them both my phone number and a way to contact me via email. In 32 years of being a family physician I have had this privilege abused less than 5 times. On the flip side it has led to many occasions where I have been able to expedite care and save countless number of office visits, ER visits and hospitalizations. That is patient-centered care and I personally feel better for it.”
Dr. Howard Luks is an orthopedic surgeon also has experienced similar benefits.
“Physicians underestimate the fact that opening up a digital channel to facilitate post visit, post-surgery, etc. comments and questions can and does provide a very real ROI if you dive into the typical workflow pattern that evolves when a patient calls with questions. If my assistant or nurse is tracking me down after fielding a phone call, they are not available to perform work that will lead to income. If I can answer a question with a brief email it saves everyone time and enables him or her to remain active in meaningful tasks. So… there are tangible reasons why the use of digital communications in this day and age are worthwhile, but many are not savvy enough to realize the upsides and fear that they will be inundated with an enormous number of useless emails. I can tell you that it never happens and patients start most every email with ” sorry, but I …”. They are very respectful of the opportunity to engage in this format and they are very cognizant of the fact that it does take away from my other clinical related activities."