Physicians' use of email with patients: Factors influencing electronic communication and adherence to best practices
Physicians' use of email with patients: Factors influencing electronic communication and adherence to best practices
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DOI：
10.2196/jmir.8.1.e2
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发表时间：
2006-01-01
影响因子：
7.4
通讯作者：
Menachemi, Nir
中科院分区：
文献类型：
--
作者：
Brooks, Robert G.;Menachemi, Nir
背景：随着公众越来越多地使用互联网，使用电子邮件作为患者和医生之间的沟通手段可能会增加。然而，尽管有证据表明患者对电子邮件的兴趣有所增加，但医生在临床护理中使用电子邮件的速度一直很慢。目的：探讨医患电子邮件的相关因素，并报告医生遵守公认的电子邮件沟通指南的情况。方法：横断面调查（2005年3 - 5月）对佛罗里达州所有初级保健医生（n = 10253）和25%分层随机抽样的所有门诊临床专家（n = 3954）进行调查。对医生进行了关于患者使用电子邮件、遵守公认指导方针和人口统计数据的调查。结果：共4203名医生完成问卷，参与率为28.2%。其中，689人（16.6%）曾亲自使用电子邮件与患者沟通。只有120人（2.9%）经常使用电子邮件与患者沟通。在单变量分析中，电子邮件的使用与医生的年龄（减少使用：年龄61岁；P = 0.014）、种族（减少使用：亚洲背景；P < .001）、医疗培训(增加使用：家庭医学，P =. 001；或外科专业，P =. 007；但与内科无关，P =。112)、执业规模（50名医师，P < 0.001）和地理位置（城市17.2% vs农村7.9%,P < 0.001）。多变量模型显示，只有实践规模大于50 （OR = 1.94; 95% CI = 1.01-3.79）和亚裔美国人种族（OR = 0.26; 95% CI = 0.14-0.49）与患者使用电子邮件有关。值得注意的是，只有46名医生（6.7%）至少遵守了13项电子邮件沟通指南中的一半。结论：这项对门诊执业医师的大型调查显示，在采用电子邮件通信方面只有适度的进步，并且很少遵守公认的电子邮件通信指南。需要进一步努力教育患者和医生电子邮件通信的优点和局限性，并消除采用电子邮件的财政和法律障碍。
Background: With the public's increased use of the Internet, the use of email as a means of communication between patients and physicians will likely increase. Yet, despite evidence of increased interest by patients, email use by physicians for clinical care has been slow.Objective: To examine the factors associated with physician-patient email, and report on the physicians' adherence to recognized guidelines for email communication.Methods: Cross-sectional survey (March-May, 2005) of all primary care physicians (n = 10253), and a 25% stratified, random sample of all ambulatory clinical specialists (n = 3954) in the state of Florida. Physicians were surveyed on email use with patients, adherence to recognized guidelines, and demographics.Results: The 4203 physicians completed the questionnaire (a 28.2% participation rate). Of these, 689 (16.6%) had personally used email to communicate with patients. Only 120 (2.9%) used email with patients frequently. In univariate analysis, email use correlated with physician age (decreased use: age > 61; P = .014), race (decreased use: Asian background; P < .001), medical training (increased use: family medicine, P = .001; or surgical specialty, P = .007; but not internal medicine, P =. 112), practice size (> 50 physicians, P < .001), and geographic location (urban 17.2% vs. rural, 7.9%; P < .001). Multivariate modeling showed that only practice size greater than 50 (OR = 1.94; 95% CI = 1.01-3.79) and Asian-American race (OR = 0.26; 95% CI = 0.14-0.49) were related to email use with patients. Remarkably, only 46 physicians (6.7%) adhered to at least half of the 13 selected guidelines for email communication.Conclusions: This large survey of physicians, practicing in ambulatory settings, shows only modest advances in the adoption of email communication, and little adherence to recognized guidelines for email correspondence. Further efforts are required to educate both patients and physicians on the advantages and limitations of email communication, and to remove fiscal and legal barriers to its adoption.