Published online October 1, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. 701-706 (doi:10.1542/10.1542/peds.2007-1094)
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ARTICLE

Patient-Physician E-mail: An Opportunity to Transform Pediatric Health Care Delivery

Paul Rosen, MD, MPH, MMMa,b and C. Kent Kwoh, MDc,d

a Departments of Pediatrics
c Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
b Division of Rheumatology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
d Division of Rheumatology, Veterans Administration Pittsburgh Healthcare System, Pittsburgh, Pennsylvania

OBJECTIVE. The objectives of this study were to assess the patterns of patients who use a patient-physician e-mail service, measure physician time required to answer a patient question via e-mail compared with that via telephone, and determine the satisfaction of families who are provided e-mail access to their child's rheumatologist.

METHODS. A consecutive series of patients' families were offered e-mail access during a 2-year period. Data regarding patient e-mail use were collected, including urgency of message, subject matter, message volume, and time of day of messaging. The duration of the pediatric rheumatologist's e-mail interactions and telephone interactions with patients was measured using a stopwatch. After 1 year of enrollment in the patient-physician e-mail service, families were mailed a 12-item satisfaction survey regarding their e-mail experience.

RESULTS. A total of 306 of 328 families who were offered patient-physician e-mail access enrolled, and 121 used the service. The patients sent 40% of their e-mails outside business hours. Messages that were urgent (notification of disease flare, notification of new symptoms, or parent expectation of same-day response) made up 5.7% of the e-mails sent to the physician. Messages that required emergent attention made up 0.002% of the e-mails to the physician. Answering patient questions by e-mail was 57% faster than using the telephone for the physician. The physician received 1.2 e-mails per day from patients. The families who responded to the survey agreed that patient-physician e-mail increased access to the physician and improved the quality of care. The families did not find that patient-physician e-mail distanced them from their child's doctor.

CONCLUSIONS. Patient-physician e-mail is a service that patients will use given the opportunity. The e-mail service enables physicians to answer medical questions with less time spent compared with telephone messaging. In our experience in an academic pediatric subspecialty practice, patients reported enhanced communication and access with the e-mail service.

Key Words: e-mail

Abbreviations: IOM—Institute of Medicine • PPEM—patient-physician e-mail • HIPAA—Health Insurance Portability and Accountability Act

Accepted May 10, 2007.


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