Physician-Patient Electronic Communication Curriculum Manual

Physician-Patient Electronic Communication Curriculum Manual Physician-Patient Electronic Communication Curriculum Manual Katrina Miller, MD1 Heather Paladine, MD2 Brett White, MD3 Chris Feifer, DrPH4 Corresponding Author: Heather Paladine, MD Assistant Clinical Professor of Medicine New York Presbyterian/Columbia University Medical Center Center for Family and Community Medicine 610 West 158th St New York, NY 10032 212-544-1864 hlp11@columbia.edu March 2010 Assistant Professor, Clinical Faculty, Glendale Adventist Family Practice Residency Program, Glendale, California Assistant Clinical Professor of Medicine, New York Presbyterian/Columbia University Medical Center, Center for Family and Community Medicine Assistant Professor, Oregon Health and Sciences University Department of Family Medicine, Keck School of Medicine, University of Southern California Physician-Patient Electronic Communication Curriculum Manual Table of Contents Guide for Presenters Part One: Background, Terminology, Security and Guidelines, Informed Consent and Documentation Slides and Speaker Notes Handouts Terms and Definitions AMIA Guidelines Sample Office Policy Sample Office Policy Sample Patient Handout Sample Consent Form Sample Consent Form Part Two: Appropriate Communications, Problem Situations and Sample Scenarios Slides and Speaker Notes Handouts Sample Emails 16 18 19 21 24 25 26 28 37 Suggestions for After Completion of Curriculum 55 References and Suggested for Further Reading 56 Physician-Patient Electronic Communication Curriculum Manual Guide for Presenters Welcome to our curriculum As you know, electronic communication is a very important aspect of life in the 21st century Patients are very interested in online information and electronic communication with their health care provider There are potentially serious medico-legal ramifications of email use in the physician/patient relationship that must be addressed Due to a need we saw in our Family Medicine Residency program, and in accordance with the tenets of the Future of Family Medicine Project our group has developed this curriculum in order to help residents and attending physicians understand and feel more comfortable with electronic communication with their patients This curriculum is part of a research study started in 2007 to evaluate and improve the knowledge, skills and deficiencies regarding physician-patient electronic communication The study and curriculum were made possible by an STFM Foundation Grant through the Group on Information Technology 1) Curriculum Materials • The curriculum includes two PowerPoint presentations, which are designed to be taught during a one-hour resident didactic sessions • Notes for faculty presenters are included in this manual (in italics under the slide text), and are available as well as in the notes section of many PowerPoint slides This manual or “Notes” pages can be printed from the PowerPoint files for use as a guide during the presentation • Note that some slides are set to reveal the slide text on a second click of your mouse or keyboard This “progressive reveal” allows the group to discuss the question on the slide before our answers are revealed • The PowerPoint slides are represented in this manual with a number header that refers to the presentation number (1 or 2) and the slide number (1-30) So slide “1-10” is in the first presentation, slide number 10 • Handouts accompany each presentation You may choose to share these electronically or on paper Make sure to print or otherwise provide the “Sample Emails” in the second presentation for discussion 2) Educational Objectives • The presentations begin with educational objectives for that section • Specific ACGME competencies are indicated in the notes 3) Terms • Although we use the terms “email” or “electronic communication” throughout the curriculum, the content addresses various forms of electronic communication, including secure web portals, but deferring discussion of short form electronic communication such as texting or “Twitter” • Additionally, although we use the term physician-patient electronic communication, we realize that your residency program may have other types of providers Physician-Patient Electronic Communication Curriculum Manual 4) Curriculum Implementation • For help with curriculum implementation, contact us through Dr Paladine at hlp11@columbia.edu • The complete curriculum and all materials are available on www.fmdrl.org • Please feel free to present all slides provided in the curriculum, as they are provided, or as you see best for your program, adding art or custom animation These modifications were kept to a minimum in the master presentations Physician-Patient Electronic Communication Curriculum Manual SLIDES AND SPEAKER NOTES- PART ONE The curriculum is divided into two parts The suggested time commitment is one hour for each part This is the first PowerPoint presentation Make sure to print handouts that you may want to use before the presentation (See pages 12-24) _ _ 1-1 Physician-Patient Electronic Communication Curriculum: PART ONE Katrina Miller, MD Heather Paladine, MD Brett White, MD Chris Feifer, DrPH This curriculum was developed by Family Medicine colleagues with the help of an STFM Grant 1-2 Corresponding Author Heather Paladine, MD Assistant Clinical Professor of Medicine New York Presbyterian/Columbia University Medical Center Center for Family and Community Medicine 610 West 158th St New York, NY10032 212-544-1864 hlp11@columbia.edu 1-3 Overview of Curriculum •Part 1: Background, Terminology, Security and Guidelines, Informed Consent and Documentation •Part 2: Appropriate Communications, Problem Situations and Sample Scenarios Notes: The curriculum is divided into parts The suggested time commitment is one hour for each part Physician-Patient Electronic Communication Curriculum Manual 1-4 Background, Terminology, Rules and Regulations, Documentation and Informed Consent Objectives: At the completion of this section, the learner will be able to: •Define specific terms and guidelines related to physician-patient electronic communication •Discuss security issues with regard to electronic communication •Identify guidelines for electronic communication •Complete an informed consent with a patient Notes: ACGME competencies: Practice based learning and improvement, Systems based practice 1-5 Part 2: Appropriate Communications, Problem Situations and Practice Scenarios Objectives: At the completion of this section, the learner will be able to: •Understand appropriate electronic communication •Understand inappropriate patients with whom to communicate electronically •Understand inappropriate topics for electronic communication •Recognize how and when to end electronic communication and change to another form of communication •Critique electronic communication with patients based on presented guidelines Notes: ACGME competencies: Patient care, Professionalism, Interpersonal and Communication skills, Practice based learning and improvement 1-6 First, Some Definitions: •What we mean by electronic communication? •Electronic Communication –Asynchronous online communication with patients -email or secure web portal •We are not including short phrased, real-time texting, chatting or Twitter, etc.* Notes: *These types of communication with patients may be more used in the future and will necessitate similar focus, but are not addressed in this presentation Physician-Patient Electronic Communication Curriculum Manual 1-7 First, some definitions (cont): •Web-based Email –Email accessible from any internet capable device •Portal or Secure Website Messaging –Online website that provides services, such as email, links to other sites and media –Usually has a separate username and password –Generally has more security features than web-based email •Physician-patient communication may use either system Notes: The Terms and Definitions handout goes along with this section Depending on your audience’s familiarity with these terms, you may choose to review the handout now or distribute as a reference 1-8 Discuss: Why use electronic communication with patients? What you think? •Email communication is ubiquitous -70% of people in the U.S have access to email •Among low income Americans, more than 1/3 have email access •Electronic communication can be a time saver and avoid phone tag •Electronic communication is easy to document and archive •Electronic communication can be reimbursed •Many patients want to email their doctors Notes: Text in italics on the slide refers to discussion points The bullet points on the slide will appear the second time you advance the slide Have the group brainstorm some of their own answers before you give them ours http://www.internetworldstats.com/stats2.htm Hsu et al Use of e-Health Services between 1999 and 2002: A Growing Digital Divide J Am Med Inform Assoc 2005; 12: 164-171 Physician-Patient Electronic Communication Curriculum Manual 1-9 Why Learn About Electronic Communication with Patients? •Electronic communication is becoming more common -you are likely to get requests from patients •1/3 of patients would be willing to pay extra for email access –About half say that email access would influence their choice of doctors or health plans •The majority of patients who email would like to email their physicians (90%) –However, only 10-15% of patients have used email with their doctors •It’s important to know potential benefits and pitfalls so that you can decide if you want to add this to your future practice Notes: The bullet points on the slide will appear the second time you advance the slide Have the group brainstorm some of their own answers before you give them ours http://www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2002Vol2_Is s08.pdf In Boston, up to 75% of primary care physicians have used email with 5% of their patients Leong et al Enhancing Doctor-Patient Communication Using Email: A Pilot Study The Journal of the American Board of Family Practice, 2005; 18:180-188 Patients are very interested in online information and email communication with their practitioners BMJ 2004;328:1148-1149 (15 May) 1-10 Integrated Electronic Health Record (EHR) •Web-enabled electronic health documentation that has electronic communication as part of the system •Electronic medical information is accessible for communication, e.g., labs results, chart notes •Messages are automatically saved as part of the Electronic Health Record 1-11 What does HIPAA say about electronic communication with patients? •The Health Insurance Portability and Accountability Act •HIPAA requires: “appropriate administrative, technical and physical safeguards to protect the privacy of patient information” Physician-Patient Electronic Communication Curriculum Manual 1-12 What does HIPAA say about electronic communication with patients?(cont) •Regulations don't name a particular technology •Wide range of options: –Portal technology –Password protection –Various types of encryption* Notes: *see “Terms and Definitions” 1-13 Is Encryption Mandatory? •Under HIPAA email encryption is not mandatory •However, encryption is an appropriate and cost-effective method of email security What you think? •Do you think email is secure for confidential transmission of health information? Notes: Progressive reveal There is no correct answer to this question! This is why informed consent, discussed later in the presentations, is so important 1-14 Risks of Using Electronic Communication -What you think? •Emails may not be secure and therefore it is possible that the confidentiality of such communications may be breached by a third party •Electronic communication can be intercepted, circulated, forwarded, and broadcast to or used by unintended recipients •Electronic communication may be stored electronically and on paper and found or used by inappropriate parties •Senders can easily misaddress a message Notes: The bullet points on the slide will appear the second time you advance the slide Have the group brainstorm some of their own answers before you give them ours 1-15 Risk of Using Electronic Communication •Email can contain computer viruses •Employers and on-line services have a right to inspect email transmitted through their systems Physician-Patient Electronic Communication Curriculum Manual •Electronic communication can be used as evidence in court 1-16 Electronic Communication Guidelines •The most commonly cited are provided by the American Medical Informatics Association (AMIA) AMIA White Paper Beverly Kane, MD, and Daniel Z Sands, MD, MPH, for the AMIA Internet Working Group, Task Force on Guidelines for the Use of Clinic-Patient Electronic Mail JAMIA 1998; 5: 104-111 Notes: These are the most commonly cited guidelines on physician-patient email The full text of this article may be accessed at: http://www.amia.org/mbrcenter/pubs/email_guidelines.asp 1-17 AMIA Communication Guidelines •Establish turnaround time for messages Do not use email for urgent matters •Establish types of transactions (prescription refill, appointment scheduling, etc.) and subject matter (generic questions, lab results) permitted over email •Inform patients about privacy issues Patients should know: Who besides addressee processes messages –During addressee's usual business hours –During addressee's vacation or illness Notes: These guidelines are divided into communication guidelines and medicolegal/administrative guidelines 1-18 AMIA Communication Guidelines (cont) •Instruct patients to put category of transaction in the subject line of message for filtering: "prescription," "appointment," "medical advice," "billing question." •Avoid sensitive terms in subject line, for example: “HIV question” •Request that patients put their name and date of birth or patient identification number in the body of the message, not the subject line 1-19 AMIA Communication Guidelines (cont) •Configure automatic reply to acknowledge receipt of messages Request that patients use autoreply feature to acknowledge receiving provider's message •Send a new message to inform patient of completion of request (such as a prescription refill) •Avoid anger, sarcasm, and criticism in messages •Document all messages: either electronic charting or print copy of email in the patient’s paper chart 10 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email From: Sent: To: Subject: DS Friday, January 8, 2008 8:55 AM Doc Orthotics Good Morning Doc, Back on January 31, 2008, Dr G, the Podiatrist I was authorized to see, wrote two prescriptions for me One was for a pair of orthotics, and the other was for 12 capsals of Diflucan for the fungal infection on my left foot Dr G works with H-S for customed Orthotics They would not accept the prescription, because I have an HMO H-S requires an authorized referral addressed to them, in order to make my orthotics On February 8, 2008, I faxed the Orthotics prescription, with background information to Ms J, who I was told handled authorizations for referrals I also delivered the original of the prescription to her, personnally, later that day I also faxed a copy of the Diflucan prescription to I’ssis Ramirez' attention, to get authorization for that prescription To date, nothing has come in the mail Nor have I received verbal notification of the status I will try Ms J later on this morning, during my break Yesterday, I left another message for Ms R I haven't heard from her since I call and left a message to confirm her receipt of the fax I sent Would you let me know who I should talk to about getting the status of these two requests? Any assistance is gratefully appreciated By the way, since January 29, 2008, I have committed to eating Fish Seafood and lots of veggies (Brocoli and Cawliflower) I have replaced Hamburger and Turkey Burgers with Veggie (Soy) Burgers Sodas have been replaced with Lipton brand Green Tea drinks and Glaceau Fruit Waters Well, it's beddy Bye time Hope to speak with you soon DS QUESTIONS: 1) How would you respond to this email? 2) Should this email be handled by another member of your staff? 45 Physician-Patient Electronic Communication Curriculum Manual 3) Would you provide any counseling for this patient regarding email content? Group Sample Email From: Sent: To: Subject: BG Wednesday July 2, 2008 9:32 PM Dr A Heart Problem Hi Dr A I don't know if you remember me I'm on vacation now in Arizona and I'm afraid the problem with my heart may be coming back It was racing pretty quickly today and I have some pain that comes and goes I don't know any doctors here and don't want to wait in the emergency room Should I cut short my trip and fly home? Please let me know! BG QUESTIONS: 1) What are some concerns about this email? 2) How would you respond to this email? 3) Are there medico-legal issues raised in this email? 46 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email From: Sent: To: Subject: HG Sunday, June 9, 2008 6:33 PM Dr P A few issues… Hello Dr P It's been about two weeks since I was in your office and I have been taking the meloxicam and the tramadol as prescribed and doing my PT but I am still in a lot of pain In in the stretching and PT I have been trying to distinguish between muscle tightness and the pain associated with that and this inflammation/nerve pain and I tell you I don't feel like I am making progress I get some temporary relief from stretching but it's followed by intense pain and lack of mobility I am having trouble standing up/upright from a seated position I would like to go back and see a orthopedic specialist but I believe I need you to put in a referral request with my insurance company as that takes a minute I would also like to ask what else I can to manage the pain With the meloxicam what else can I take between dosages? I also got a letter from you that my cholesterol was up but there was no attachment to tell me what the new number is vs where it was the last time we checked it Thanks, HG QUESTIONS: 1) How would you respond to this email? 2) Would you ask this patient to come in to see you? 3) How would you address the cholesterol issue? 47 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email From: ES Sent: Sunday, June 1, 2008 11:55 PM To: Dr D Subject: Does my hemorrhoid need surgery or not? Dr D, I have an enlarged bleeding hemorrhoid I have been seen by two doctors at the clinic with two conflicting courses of treatment I have serious doubts about the current course of treatment I would like your opinion Here is the complete story On Friday, November 23, I had a movement with a hard stool This irritated an existing small external hemorrhoid that was previous diagnosed Last year you referred me to a GI doctor because of the gas pain I was having He noted the hemorrhoid during his examine When I was examined in 2004, there was not mention of the hemorrhoid The hemorrhoid enlarged and became painful after passing the hard stool Initially, I didn’t worry about it I increased my fiber intake, drank more water, and walked more, i.e., the normal treatment On Monday, I noticed a small streak of blood on the toilet paper after a movement This happens occasionally, and I’ve been told it is not unusual Tuesday, there was not blood Wednesday, the hemorrhoid starting bleeding and hasn’t stopped I went to the clinic at about 1:00pm Wednesday and told the person in the reception area what the problem was She went and talked to someone and came back saying it wasn’t urgent but to come back at 2:45pm I came back, and was seen by a doctor Unfortunately, I cannot remember her name She is the doctor I saw when I dislocated my patella She gave me the standard hemorrhoid speech saying what they are and the standard treatment She mentioned that removal was done in rare conditions such as when a blood clot was in the hemorrhoid This is very important I remember her saying this She then did the examination The examination did not take long and afterward, she stated with certainty that the hemorrhoid had to be removed because of a blood clot I asked when this was going to be done She said immediately, as soon as the referral paperwork was done She came back a few minutes later and said the attending doctor did not agree with her and to continue with the standard treatment She did not sound convincing when recommending this treatment plan She told me to go to the emergency room if it got worse I’m wondering if she was encouraging me to this When I asked more question she seemed evasive in her answers, especially when I asked about the blood clot On Thursday morning, the bleeding had seemed to get slightly worse I complained to the clinic wondering how the doctor that did the examination got overruled by a doctor who did not an examination I got a call from Dr G, who was the attending Doctor that made the decision She 48 Physician-Patient Electronic Communication Curriculum Manual told me the doctor who did the examination came to her and asked what should be done and the decision was made jointly I then went over to Family Practice and Dr G did an examination She confirmed there is a blood clot She said the amount of bleeding was not excessive and defended her course of treatment I felt better after the visit but I had lingering doubts because the first doctor seemed so confident in her course of treatment Because of these doubts I did a web search looking for the treatment of hemorrhoids with blood clots Overwhelming, the results are for the removal of the hemorrhoid with some saying immediately In fact, I found none that recommended the standard treatment because of potential problems of not removing the clot There is a WebMD article that has all the points mentioned by the doctor who did the first examine, including removal is not normally done but should be done if the hemorrhoid has a blood clot I appreciate any input ES QUESTIONS: 1) How would you respond to this email? 2) Are there any red flags in this email? 3) Should you see this patient in the clinic for follow-up? 4) How should you counsel this patient about email content? 49 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email From: Sent: To: Subject: EW Tuesday October 21, 2008 7:14 AM Dr C My baby is choking Dr C, thank you for filling out my form for WIC baby D has an appointment with you next month but has been acting weird lately I don't know if she has a cold or what? she seems to choke when she is eating and I don't know how good her breathing is she had a little fever after she got the shots in your office but I think she's over that now can you tell me what to do? EW QUESTIONS: 1) What are some concerns about this email? 2) How would you respond to this email? 3) What medico-legal issues raised in this email? 50 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email 10 From: Sent: To: Subject: AL Wednesday, March 31, 2008 3:22 PM Dr V reflux, I think? Hi Dr V, I hope things are well I am writing to ask you about some reflux I've been having for the past month or so This is the first time I've experience this We spoke a bit about this at my last appointment with you It has continued to be a problem At the time I thought it was due to overeating and eating late at night Well, I've been going to Weight Watchers and have lost weight and have been eating much smaller portions but still have this problem Last night I ate around 7:00 pm a very spicy tomato-based chicken soup about 15 minutes after the meal (I ate very little) I had some very painful heartburn and took a walk to calm it down I also took a charcoal pill a neighbor who has similar problems uses It helped a bit I guess my question is what I should do? I am also wondering if this could be a symptom of the high blood pressure pill I take? I started having these problems around the same time that I started taking this pill Do I have GERD? These are questions that I have Should I take an antacid? I've never had this problem so I don't know what the best course to take I would also prefer not to take more prescription medication for the problem if it is not necessary Thank you, AL QUESTIONS: 1) How would you respond to this email? 2) What recommendations would you provide over email? 3) How would you address the “charcoal pill” issue? 51 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email 11 From: Sent: To: Subject: Importance: AH Monday, February 04, 2008 2:09 PM Dr F Pain Medication High Hi Dr.F, Back in July of last year Dr X gave me a prescription for Vicodin 500mg tablets for severe abdominal pain to take as needed I just ran out of that prescription and am having an attack and need some pain meds If you can would you call this in to my local pharmacy? I would be forever grateful Thank you very much, AH QUESTIONS: 1) How would you respond to this email? 2) What conditions/situations are not appropriate to address through email? 3) How could you formulate an institutional policy to address this type of email? 52 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email 12 From: Sent: To: Subject: SG Wednesday, May 14, 2008 5:46 PM Dr P I ran out of birth control pills Hi Dr.P, I ran out of my birth control pills weeks ago and I’m pregnant again I took a test from the drugstore and it had a plus sign I heard that there were pills I could take that would stop me being pregnant Can you just call those in to the pharmacy for me ASAP so I can take care of this? I already had abortions and not want to have another Thank you SG QUESTIONS: 1) How would you respond to this email? 2) How does the subject line relate to the body of the text? 3) How should this be addressed? 53 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email 13 From: Sent: To: Subject: FR Thursday, April 9, 2008 4:01 PM Dr Z A few things Dr Z, I am writing to inform you that I had my hernia repair surgery last Friday, October 5th Everything appears to have gone well The hernia was a small unincarcerated inguinal hernia on the left side I had the pre-op work done September 27th I asked if my cholesterol levels were being checked I was told a cholesterol panel was being done and I asked that a copy be sent to you Hopefully, you received it The surgery was done without lidocaine Bupivacaine (Marcaine) was used instead The anesthesiologist recommended using lidocaiane saying that the dental procedures being near the brain and the rarity of side affects made bad reactions unlikely I said “no”, and I think Dr C supported my decision After the surgery when my brother was driving me home I noticed something I was tired and not fully alert, but I wasn’t light-headed After my other surgeries, cholecystectomy (2002), appendectomy (2003), incisional hernia repair (2004), I was tired, not fully alert and light-headed The light-headedness lasted a couple of days I attributed it to the medications I was receiving That may be the case but the other times I received lidocaine as part of the procedure I have November 16th scheduled for the collarbone repair Dr V told me to have you the preop work I will make an appointment shortly to set that up Thanks, FR QUESTIONS: 1) How would you respond to this email? 2) Would you request to see this patient in the clinic for evaluation of the “not fully alert” symptom? 3) What are some medico-legal risks that could relate to this case? 54 Physician-Patient Electronic Communication Curriculum Manual Group Sample Email 14 From: Sent: To: Subject: Importance: JD Friday, March 18, 2008 4:33 PM Dr G Need my results today!! High Hi Dr.G, I came to clinic yesterday to get an HIV test and I still haven’t gotten the results—I am going out of town this weekend and really need to know the results, please call me on my cell phone—213555-1234 Help! JD QUESTIONS: 1) What are some concerns about this email? 2) How would you respond to this email? 3) How could you educate this patient about appropriate use of email? 55 Handout – Part Physician-patient Email Communication Curriculum Group Sample Email 15 From: Sent: To: Subject: PT Wednesday, May 14, 2008 5:46 PM Dr Y Your horrendous care DR Y: I think you are seriously negligent in your care of me As you well know I am on multiple medications that need to be refilled often I am in pain all the time and need my pain medication in order to live I called your office yesterday to get my Oxycontin and Oxycodone refilled and your office staff said that I had to come in to the clinic for this I was just there weeks ago!! There is no way I can come to your office so often as I have a copayment of $25 as you know This is a ridiculous situation and you must something to figure it out I cannot get here and there so easily and my pharmacy has said that they will take these prescriptions as a phone call I will go again today to try and pick them up If you not take care of me better I will find another doctor who can I don’t understand how you can this to people PT QUESTIONS: 1) How would you respond to this email? 2) How you address issues raised regarding offices other than your own? 3) What medico-legal matters are raised in this email? 56 Handout – Part Physician-patient Email Communication Curriculum Suggestions for after completion of curriculum • • • • • • Your program may choose to create a number to competency for emails We suggest 3-5 emails be precepted before residents are considered competent Perhaps your program will desire all emails to be precepted- this may depend on the requirements of your program, your residents or your email system (some portals require a signoff by a faculty physician before being sent to the patient) Perhaps choose a preceptor responsible for email precepting This could be the resident’s advisor or the preceptor on for the day Remain diligent about consent forms and emails being appropriately documented as a part of the medical record Please be a part of our post-curriculum survey and give us your suggestions! 57 Physician-patient Email Communication Curriculum References and Suggestions for Further Reading Borowitz SM, Wyatt JC The Origin, Content, and Workload of E-mail Consultations JAMA 1998; 280:1321-1324 Brewer B Doctors Reluctant to Reach Patients Online WSJ The Doctors Office JULY 9, 2008 http://online.wsj.com/article_email/SB121555256426937107lMyQjAxMDI4MTE1NjUxNTYyWj.html Accessed October 4, 2008 Car J, Shiekh A Email consultations in health care: 2—acceptability and safe application BMJ 2004;329:439-442 (21 August), doi:10.1136/bmj.329.7463.439 Demott K Virtual Visits Free Physicians, Patients Family Practice News 2008; 38: Eysenbach G, Diepgen TL Responses to Unsolicited Patient E-mail Requests for Medical Advice on the World Wide Web JAMA 1998; 280:1333-1335 Guidelines for Physician-Patient Electronic Communications AMA http://www.ama-assn.org/ama/pub/category/2386.html Accessed October 4, 2008 Harris Poll on Physician-Patient Email: www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2002Vo l2_Iss08.pdf Accessed October 4, 2008 HIPAA Security Guidance for Remote Use of and Access to Electronic Protected Health Information CMS http://www.cms.hhs.gov/SecurityStandard/ Accessed October 4, 2008 Hodge et al Legal Issues Concerning Electronic Health Information: Privacy, Quality, and Liability JAMA 1999; 282: 1466-1471 10 Hsu et al Use of e-Health Services between 1999 and 2002: A Growing Digital Divide J Am Med Inform Assoc 2005; 12: 164-171 11 Kane B, Sands DZ for the AMIA Internet Working Group, Task Force on Guidelines for the Use of Clinic-Patient Electronic Mail Guidelines for the Clinical Use of Electronic Mail with Patients JAMIA 1998; 5: 104-111 http://www.amia.org/mbrcenter/pubs/email_guidelines.asp Accessed November 1, 2008 12 Kleiner KD, Akers R, Burke BL, Werner EJ Parent and Physician Attitudes Regarding Electronic Communication in Pediatric Practices Pediatrics 2002; 109: 740-744 13 Leong, SL, Gingrich D, Lewis PR, Mauger DT, George JH Enhancing DoctorPatient Communication Using Email: A Pilot Study The Journal of the American Board of Family Practice 2005; 18:180-188 58 Physician-patient Email Communication Curriculum 14 Mandl KD, Feit S, Peña BM, Kohane IS Growth and Determinants of Access in Patient E-mail and Internet Use Arch Pediatr Adolesc Med 2000; 154:508-511 15 Mandl KD, Kohane IS, Brandt AM Electronic Patient-Physician Communication: Problems and Promise Ann Int Med 1998; 129: 495-500 16 Morasch LJ Making the most of Physician-Patient Email http://med.fsu.edu/informatics/Articles/Smart%20Practices%20Making%20the %20Most%20of%20Physician-Patient%20E-mail.htm Accessed October 4, 2008 17 New Guidelines Help Physicians Choose among Online Patient Communication Options; Physician practices find email communication improves productivity and generates income November 17, 2003 CHCF http://www.chcf.org/press/view.cfm? itemID=21601 Accessed October 4, 2008 18 Pallen M Guide to the Internet: Electronic mail BMJ 1995;311:1487-1490 19 Reese S Pick up the mouse, put down the phone Medical Economics 2008; 85: 2426, 28, 30 20 Spielberg AR On call and online: sociohistorical, legal, and ethical implications of email for the patient-physician relationship JAMA 1998; 280: 1353-9 21 White, CB et al A Content Analysis of E-mail Communication between Patients and Their Providers J Am Med Inform Assoc.2004; 11: 260-267 59 ... Inform Assoc 2005; 12: 164-171 Physician-Patient Electronic Communication Curriculum Manual 1-9 Why Learn About Electronic Communication with Patients? ? ?Electronic communication is becoming more... handout 12 Physician-Patient Electronic Communication Curriculum Manual 1-27 Electronic Communication- Policy and Procedure (cont) •In addition, response to a patient's electronic communication. .. Communication Curriculum: PART ONE 15 Physician-Patient Electronic Communication Curriculum Manual Terms and Definitions Electronic Health Record The full functionality of systems which use electronic