E-mail consultations must be documented, says study

A study in Finland has found that communication by e-mail between doctors and their patients is already extremely common, so much so that electronic patient record systems that are being developed should contain the functionality to document all communication.

Johanna Castren and Marja Niemi, from the University of Tampere, Finland, and Marja Niemi, from the National Research and Development Centre for Welfare and Health, studied all doctors at the state-owned Finnish Student Health Service and asked them to log e-mail correspondence with their student patients.

79% of all doctors reported using e-mail with their patients, with one doctor reporting a total of 96 e-mails per week. 21% of those surveyed received more e-mails than they did phone calls. However, up to 73% of all e-mails received were left unrecorded in the patients’ electronic health records.

"Our study indicates that email communication really constitutes a part of patient work. This should be taken into account in planning working time and daily timetables," said the study authors. "A system allowing retrieval of patient’s identity safely and with no need to register separately the email  communication in the EPR would promote the patient’s adequate treatment and reduce the physician’s medico-legal risks."

According to the study, around 20% of phone calls made to the surgery could have been replaced by e-mail communication. One in ten emails prompted a face-to-face consultation. The system used by the FSHS was simple, unprotected e-mail, without any links to the electronic health records.

"Even if university students do not represent the whole population, they can act as a ‘pilot population’ representing adults of working age of a future information society," said the authors. They recommended further and more extensive study into patients’ e-mail habits, and how doctors recorded communication.

The study, published in the open access journal BioMed Central, can be downloaded from the website here.