A content analysis of e-mail communication between patients and their providers: Patients get the message
A content analysis of e-mail communication between patients and their providers: Patients get the message
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DOI：
10.1197/jamia.m1445
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发表时间：
2004-07-01
影响因子：
6.4
通讯作者：
Katz, SJ
中科院分区：
文献类型：
--
作者：
White, CB;Moyer, CA;Katz, SJ
目的：由于多种原因，电子邮件在临床环境中的使用进展缓慢，其中包括医疗服务提供者担心患者对该技术的不当和低效使用。本研究检查了患者与医生电子邮件的随机样本内容，以确定这些担忧的有效性。设计：对患者与医生的电子邮件进行了定性分析。测量：作为在两个初级保健中心（包括 98 名医生）基于分类的电子邮件系统的随机对照试验的一部分，在 11 个月内总共收集了 3,007 封患者与医生的电子邮件；随机选择 10% 的消息进行审核。消息跨域进行编码，例如消息类型、每封电子邮件的请求数量、包含的敏感内容、医生响应的必要性以及消息语气。结果：大多数 (82.8%) 的消息都解决单一问题。最常见的消息类型包括向医生更新信息（41.4%）、处方更新（24.2%）、健康问题（13.2%）、有关测试结果的问题（10.9%）、转介（8.8%）、“其他”（包括谢谢、道歉）（8.8%）、预约（5.4%）、索取非健康相关信息（4.8%）和计费问题（0.3%）。总体而言，信息简洁、正式且与医学相关。很少（5.1%）包含敏感内容，并且没有包含紧急消息。不到一半 (43.2%) 需要医生回复。结论：基于分类的电子邮件系统促进了适合初级保健的电子邮件交换。大多数患者遵守旨在集中内容、限制每条消息的请求数量以及避免紧急请求或高度敏感内容的指南。因此，医生对患者电子邮件内容的担忧可能是没有根据的。
Objective: E-mail use in the clinical setting has been slow to diffuse for several reasons, including providers' concerns about patients' inappropriate and inefficient use of the technology. This study examined the content of a random sample of patient-physician e-mail messages to determine the validity of those concerns.Design: A qualitative analysis of patient-physician e-mail messages was performed.Measurements: A total of 3,007 patient-physician e-mail messages were collected over 11 months as part of a randomized, controlled trial of a triage-based e-mail system in two primary care centers (including 98 physicians); 10% of messages were randomly selected for review. Messages were coded across such domains as message type, number of requests per e-mail, inclusion of sensitive content, necessity of a physician response, and message tone.Results: The majority (82.8%) of messages addressed a single issue. The most common message types included information updates to the physicians (41.4%), prescription renewals (24.2%), health questions (13.2%), questions about test results (10.9%), referrals (8.8%), "other" (including thank yous, apologies) (8.8%), appointments (5.4%), requests for non-health-related information (4.8%), and billing questions (0.3%). Overall, messages were concise, formal, and medically relevant. Very few (5.1%) included sensitive content, and none included urgent messages. Less than half (43.2%) required a physician response.Conclusion: A triage-based e-mail system promoted e-mail exchanges appropriate for primary care. Most patients adhered to guidelines aimed at focusing content, limiting the number of requests per message, and avoiding urgent requests or highly sensitive content. Thus, physicians' concerns about the content of patients' e-mails may be unwarranted.