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“You’ve got mail” is a common refrain heard by 32 million America Online subscribers. Just as the telephone transformed both American society and the practice of medicine,1 electronic communication (e-mail) is having a similar impact and will become an integral part of pediatrics. In the words of Jerome Kassirer, former editor of the New England Journal of Medicine, e-mail and electronic transfer of information has the potential to “induce cultural changes in the delivery of care even more revolutionary than any restructuring that is going on today.”2
In this issue Pediatrics, Kleiner and colleagues3 report the results of a survey of parent and physician attitudes toward the use of e-mail. The results are not surprising. The majority of families have access to e-mail, with access significantly related to family income and education. Most families want to communicate with us, and our practices, by e-mail. They express some concern about confidentiality. We, on the other hand, are quite ambivalent. Although only a small number of physicians were included in the survey, 79% indicated that they were not comfortable with e-mail communication with patients. These data are consistent with a recent survey of 834 physicians, which showed that 14% regularly or frequently use e-mail to provide clinical information to patients.4 Thirty-nine percent indicated that they do not currently e-mail clinical information but would if security/privacy were fully guaranteed, and 40% responded that even if issues of security/privacy could be resolved they would not e-mail information.
There are numerous benefits of e-mail.1,5, 6 Communication is dysynchronous; that is, the 2 parties involved do not have to be in contact simultaneously to “speak with each other,” ending needless telephone-tag. Communication is rapid, relatively inexpensive, simple, and convenient. It is available day or …
Address correspondence to Howard Bauchner, MD, 91 E Concord St, Boston, MA 02118. E-mail: howard.bauchner{at}bmc.org
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