What is the situation?
- National surveys show that patients increasingly want to be able to communicate with healthcare professionals by email.
- Email consultations have the potential to play an important role in the delivery of preventive healthcare and also in facilitating the self-management of chronic diseases.
- Use of email among patients and physicians is limited by reservations over issues such as medico-legal aspects, reimbursement and time-management.
What is the evidence?
- There is still little evidence from controlled clinical trials that theoretical benefits of email consultations can actually be translated into routine clinical practice.
- Currently, email consultations are still not commonly used. A recent study from New Zealand found that the majority of GPs (68 per cent) had not actually used email with patients (Inform Prim Care 2005; 13: 195).
- A qualitative analysis found that patient satisfaction with email consultations was very high and resulted in no apparent increase in GP workload (Inform Prim Care 2004; 12: 207).
- Email has been shown to broaden communication between patients and their dermatologist (J Am Acad Dermatol 2006; 54: 1,019).
Implications for practice
- Patients living in remote areas may benefit greatly from email consultations.
- Face-to-face visits and telephone consultations still remain patientsi preferred modes of communication for many healthcare issues, especially if they are complex or sensitive.
- IT is increasingly becoming integrated into modern clinical practice, and it is important that those using it are made fully aware of any potential pitfalls that are associated with it.
- Email may facilitate consultation with other physicians and management of patients with chronic disease.
Available guidelines
- The GPC has a guide to online consulting, ÈConsulting in the Modern Worldi. This warns practices that electronic communications systems could seriously damage the consultation process, may increase workload and also leave GPs open to legal action. It states that email exchanges are best suited to arranging repeat prescriptions or booking appointments.
- Currently, email consultations with unknown patients are considered unsafe and there are no agreed standards for such consultations.
Useful website
- Dr Louise Newson is a GP in the West Midlands and author of 'Hot Topics for MRCGP and General Practitionersi, Pas Test 2006
Key points
- Email consultations may be better suited for minor problems.
- They may not necessarily increase GPs workload.
- Confidentiality is still a problem.
