Article Date: 4/1/2001

Reaching out Electronically
Is patient e-mail communication right for your office?

Have you noticed the increasing number of e-mail messages and ads from your vendors and publishers in the last dozen times you've logged on to check your mail? Ever wonder if communicating with your patients via e-mail would work?

It seems like an efficient option, but there are pitfalls to avoid. This month, I'll discuss the current status of e-mail communication, how to decide if it's the right approach for your office and a few different uses for it.

Sign of the times

E-mail is prevalent and pervasive. Since its inception in 1971, it has gradually overtaken traditional first-class mail in volume. According to the University of California Los Angeles Center for Communication Policy, in 1998 the U.S. Postal Service only delivered 4.5% of all messages -- the rest were delivered via e-mail.

Optometrically speaking

Despite the growing use of e-mail in general, doctor-patient e-mail communication is still in its infancy. Consequently, it's a good idea to be careful about depending on e-mail for "clinically critical" communications with a patient.

For physicians, the guidelines created by medicine recommend that e-mail communications be an adjunct, rather than a replacement, for actual face-to-face office visits or telephone calls. Furthermore, e-mail should be used in "non-critical" situations such as confirming and scheduling appointments, interpreting test results and providing instructions for taking medications. Patients have a degree of certainty that if the office staff accepts a phone call, their message has been heard. E-mail gives the sender less certainty that the recipient will read the message in a timely manner.

Making the decision

Is patient e-mail communication appropriate for your office? The answer to this question depends on the way you run your office. If your staff is comfortable with computers, the Internet and e-mail, then introducing them to a patient communication program is simple.

First, establish a protocol or a manual to refer to regarding the roles and responsibilities of both your staff and your patients. Both parties should then agree on the types of transactions handled by e-mail and the necessary procedures to ensure confidentiality.

In the future, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 will create regulations to control how we'll need to handle patient medical information.

Other issues to discuss with your staff are the timeliness of e-mail replies and the placement of printed (hard copy) e-mail messages in patient charts.

The sky's the limit

There's no limit to the uses of e-mail. Here are some examples of how you can use e-mail to communicate with your patients.

Patient education. Facilitate patient research by embedding a live Universal Resource Locator (URL) in an e-mail message. A patient who clicks on the URL is immediately directed to a relevant Web site that explains a medical concept or displays a medical image.

Newsletters. Send newsletters to patients according to their profiles (age, occupation, contact lens wear, third-party payer status, etc.).

Brief news flashes. Consider sending recent healthcare news on treatment, appliances and habits that may interest a broad audience within your patient base.

Focused marketing programs. If your office is introducing new services or products, send a promotional or incentive message to your patients.

A category of e-mail marketing, called permission marketing, leverages your image. Unlike spam (slang name for Unsolicited Commercial E-mail [UCE]), healthcare permission marketing relies on the explicit or implicit permission given to doctors by their patients. This permission allows doctors to freely communicate with their patients via e-mail.

E-mail addresses

Before instituting permission marketing, obtain patients' e-mail addresses by including a line on the patient registration form for an e-mail address and a box to check for patients who accept e-mail from the office. Thereafter, create e-mail messages that are relevant to the patient, telling him more about your practice's future programs, products and services.

Store patients' e-mail addresses in traditional practice management software (PMS), then query the database to create profiles. If this isn't a current feature, ask your vendor to add it. Alternatively, you can create a data file to serve as a data warehouse from which you can create a distribution list. Distribution lists are an excellent way to broadcast e-mail messages to a broad audience.

Points to keep in mind

Whatever methods you choose to implement, refrain from making your message a nuisance. Worse yet, don't let your be program be seen as spam. The emotional revulsion that surrounds spam originates in a recurring misconception about e-mail. In contrast to real mail, where the sender pays for the message, e-mail is an expense for the recipient because he and his Internet Service Provider (ISP), on the other hand, bear the cost of these e-mails by storing and transmitting them. This cost and the concept that ISPs are forced to handle these e-mails have served as an impetus for strict permission e-mail standards and policies.

E-mail, whether for patient communications or for permission marketing can be a great way to communicate.

Dr. Hom has a rich background in e-commerce. He practiced optometry in a variety of settings and currently practices part-time in San Francisco, exclusively caring for complicated contact lens patients. He is now a partner and business development manager for Network Appliance in Sunnyvale, Calif.

Optometric Management, Issue: April 2001