How Should You Use Email in Your Practice in 2013?

In January 2007, I published a presentation on SlideShare titled, “Using email in a medical practice. An overview of risks and benefits”. (Click here to view the deck.) Since that time, the presentation has been viewed more than 6,100 times and I still receive regular comments from viewers who find the content useful and relevant. When the Canadian Medical Protective Association (CMPA) published a revised guideline on the use of email to communicate with patients and associated legal risks, I thought it would be useful to review my original presentation and see how much has changed in the seven years since it was published.

I was pleasantly suprised when reviewing my original slide deck that none of the basic principles had really changed. The CMPA guideline is a refinement of many of the recommendations. It is a very useful document and should be required reading for anyone who uses email to communicate with patients. Highlights include:

• Remembering to use the Bcc (blind carbon copy) field if sending emails to multiple individuals in a group in order to protect privacy. (I recently sent out some non-clinical emails and only realized after the fact that I had not bcc’d the recipients. Embarrassing mistake and one that is easy to make.)
• If one uses a third-party or employer/hospital email system, those parties may have the right to access the email messages. Email messages sent via one of these systems may be subject to disclosure requests in the context of litigation or an access request by the Privacy Commissioner or College of Physicians and Surgeons. One can protect against this type of access by only sending sensitive emails using a personal computer that is not used by multiple individuals.
• Consider the use of an email consent form (example from CMPA) to document consent to email communication and provide evidence that the patient has acknowledged the risks. This adds an administrative step to patient management, but could be handled by front-office staff at time of check-in or when registering new patients.
• If you use a specific email address for work-related communications, consider adding an auto-reply message to acknowledge receipt of emails.
• Avoid using acronyms in your emails as these can be very confusing to patients.
• Be aware of any applicable statutory or College requirements in your province or territory.

Beyond any general email policy, these are important additional points to consider if you use email to communicate with patients and will allow you to tweak your email processes and policies.

Do you use email in your practice currently? Do you have any guidance or advice your would like to share?