The Origin, Content, and Workload of E-mail Consultations

Borowitz, Stephen M.; Wyatt, Jeremy C.

doi:10.1001/jama.280.15.1321

Cited by 144 publications

(95 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most of the diseases or problems were uncommon. These findings are consistent with previous studies, 3,13 including 2 evaluating the overall usage of a digital health sciences library 14 and the e-mail the digital library receives. 2 In contrast, the most common medical problems in the e-mails were quite different from the most common problems seen in a general pediatrician's office 15 or in a pediatric telephone triage line, 16,17 which are primary care problems.…”

Section: Discussionsupporting

confidence: 92%

“…One third of these e-mails were pediatric-related. 2 Another study of solicited pediatric email consultations from unknown patients found that most information requests come from patients and family members who sent detailed patient-specific information 3 that was also consistent with a study of unsolicited e-mails sent to the authors of a tutorial on the temperomandibular joint. 4 Another recent report studied how physicians and Web masters (persons who run Internet sites) handled unsolicited e-mails and found a wide variation in practice.…”

mentioning

confidence: 59%

“…This is true even if only some of the e-mails, phone calls, or letters are answered and others go unanswered. If a pediatrician chooses to reply to an e-mail, there should be a disclaimer in the e-mail 3 and all correspondence should be saved as that of any other medical record correspondence. All Internet information authored by a pediatrician should also have a disclaimer because there is the potential for liability.…”

Section: Legal Issuesmentioning

confidence: 99%

See 2 more Smart Citations

A Proposed Solution for Addressing the Challenge of Patient Cries for Help Through an Analysis of Unsolicited Electronic Mail

D’Alessandro

D’Alessandro²,

Colbert

2000

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Background. Unsolicited electronic mail (e-mail) is e-mail sent to a physician from a person unknown to the physician, who is seeking professional help. The purpose of this project was to analyze unsolicited e-mails sent to a digital textbook author to: 1) characterize the e-mails, 2) determine what resources would be necessary to answer the e-mails, and 3) propose a standard approach to reply to e-mails in a helpful yet medicolegally-responsive manner.Materials and Methods. All e-mails (315) sent to a digital textbook author from October 1995 through October 1998 were abstracted. Variables included: date and location, sender type, patient age, subject, medical content, and resources necessary to answer the question. Data frequencies were obtained.Results. The most common location was the .com domain (47.6%). The most common senders were laypersons (66%). Overall, 44.4% of the e-mails concerned children. Detailed, patient-specific information was sent in 63.2% of the e-mails. The most common subjects were overviews of a disease or problem (32.4%), differential diagnosis (16.8%), and therapy/treatment questions (15.9%). The medical content covered a broad range of specialties. Specialists were overwhelmingly the resource necessary to answer the e-mails (74.9%).Conclusions. Pediatricians with educational information on the Internet can expect an increase in the number of unsolicited e-mails as Internet usage expands. Laypersons regard even short passages to mean the author is an expert in that particular area. Pediatricians need to consider the ethical and medicolegal implications of responding to unsolicited e-mails. A nonpersonalized, standard e-mail reply is proposed that directs the sender to quality information resources that may be of further assistance. Pediatrics 2000;105(6). URL: http://www. pediatrics.org/cgi/content/full/105/6/e74; unsolicited electronic mail, e-mail, medical informatics, legal issues, ethical issues, digital libraries.ABBREVIATION. e-mail, electronic mail. E lectronic mail (e-mail) is a revolutionary new way for pediatricians to communicate with their patients about their care. E-mail offers numerous advantages, including its asynchronous nature, which allows the convenience of replying when one chooses; easy clarification of meaning or instructions; and retention of the interaction, especially information conveyed, which would need to be referenced in the future. Disadvantages of e-mail include: again, its asynchronous nature leading to a variable delay between message receipt and reply, the inability to document that the message has been received and reviewed, and concerns about privacy. Recently, the American Medical Informatics Association Internet Working Group put forth guidelines to help physicians with the clinical use of e-mail with their own patients that are now being widely recommended and adopted.1 However, these guidelines did not comment on the standards that physicians should follow when unknown patients approach them for professional help via e-mail on the In...

show abstract

Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 59%

Section: Legal Issuesmentioning

confidence: 99%

See 1 more Smart Citation

A Proposed Solution for Addressing the Challenge of Patient Cries for Help Through an Analysis of Unsolicited Electronic Mail

D’Alessandro

D’Alessandro²,

Colbert

2000

Pediatrics

View full text Add to dashboard Cite

show abstract

“…E-mail communication, with patients or between clinicians, raises concerns about patient confidentiality and profes- sional liability and generally lacks mechanisms for physician reimbursement. 33,34 Given that nearly three-quarters of U.S. adults currently report e-mail or internet access, 35 the low rate of physician-patient e-mail communication suggests a lack of appropriate clinical infrastructure rather than lack of patient access. 36,37 Low use may also reflect negative attitudes, resistance, and/or inertia among physicians.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of basic information technology use by U.S. physicians

Grant

Campbell²,

Gruen

et al. 2006

J Gen Intern Med

View full text Add to dashboard Cite

BACKGROUND: Information technology (IT) has been advocated as an important means to improve the practice of clinical medicine. OBJECTIVES: To determine current prevalence of non‐electronic health record (EHR) IT use by a national sample of U.S. physicians, and to identify associated physician, practice, and patient panel characteristics. DESIGN, SETTING, AND PARTICIPANTS: Survey conducted in early 2004 of 1,662 U.S. physicians engaged in direct patient care selected from 3 primary care specialties (family practice, internal medicine, pediatrics) and 3 nonprimary care specialties (anesthesiology, general surgery, cardiology). MEASUREMENTS: Self‐reported frequency of e‐mail communication with patients or other clinicians, online access to continuing medical education or professional journals, and use of any computerized decision support (CDS) during clinical care. Survey results were weighted by specialty and linked via practice zip codes to measures of area income and urbanization. RESULTS: Response rate was 52.5%. Respondents spent 49 (±19) (mean [±standard deviation]) hours per week in direct patient care and graduated from medical school 23 (±11) years earlier. “Frequent” use was highest for CDS (40.8%) and online professional journal access (39.0%), and lowest for e‐mail communication with patients (3.4%). Ten percent of physicians never used any of the 5 IT tools. In separate logistic regression analyses predicting usage of each of the 5 IT tools, the strongest associations with IT use were primary care practice (adjusted odds ratios [aORs] ranging from 1.34 to 2.26) and academic practice setting (aORs 2.17 to 5.41). Years since medical school graduation (aOR 0.85 to 0.87 for every 5 years after graduation) and solo/2‐person practice setting (aORs 0.21 to 0.55) were negatively associated with IT use. Practice location and patient panel characteristics were not independently associated with IT use. CONCLUSIONS: In early 2004, the majority of physicians did not regularly use basic, inexpensive, and widely available IT tools in clinical practice. Efforts to increase the use of IT in medicine should focus on practice‐level barriers to adoption.

show abstract

“…Today, due to the fast growing and penetration of the INTERNET and mobile telephone technology, the IT applications in the health care environment are focused at e-consultation [2] and home care delivery [3] and the use of triage systems [4]. Home care delivery is becoming a very important issue, especially for the management of chronic diseases such as diabetes, congestive heart failure, coronary heart disease, etc.…”

Section: Introductionmentioning

confidence: 99%

Congestive heart failure management in a home-care system through the CHS contact center

Maglaveras¹,

Lekka²,

Chouvarda³

et al. 2003

Computers in Cardiology, 2003

View full text Add to dashboard Cite

show abstract

The Origin, Content, and Workload of E-mail Consultations

Abstract: Context.-Despite the common use of e-mail, little beyond anecdote or impressions has been published on patient-clinician e-mail consultation. Objective.-To report our experiences with free-of-charge e-mail consultations. Design.-Retrospective review of all e-mail consultation requests

Cited by 144 publications

References 13 publications

A Proposed Solution for Addressing the Challenge of Patient Cries for Help Through an Analysis of Unsolicited Electronic Mail

A Proposed Solution for Addressing the Challenge of Patient Cries for Help Through an Analysis of Unsolicited Electronic Mail

Prevalence of basic information technology use by U.S. physicians

Congestive heart failure management in a home-care system through the CHS contact center

Contact Info

Product

Resources

About