E-Mail Me Doc *Quick Update*

Today people use e-mail, instant messaging, and social media for everything. So the idea of e-mailing a doctor instead of spending all day on phone or visiting in-person seems antiquated and a waste of time. A doctor may think different about dealing with receiving e-mail. A doctor with 50 to 100 patients could receive many e-mails. This e-mail is to some extent is an unpaid consultation. This type of communication requires time to read and time to answer. A doctor’s time is money. Time he or she does not want to spend. Then there is the question on whether the person on the end of the e-mail is the patient or a person who has access to the patients e-mail. A question on whether transmitting patient information by e-mail could be a Health Insurance Portability and Accountability Act (HIPAA) violation. E-mail and health care can be viewed in three parts what are the benefits, what are the cons, and can it be done legally.

Electronic messaging is already the mainstream form of communication for many people today. So the idea of e-mailing or even instant messaging a doctor would seem routine. The idea of calling a doctor’s office and staying on hold for hours does not fit in the twenty first century mindset. “The potential speed, efficiency, and quality of the information transmitted through e-mail by the physician help to promote better-informed patients” (Wieczorek, 2010). People are never away from the ability to communicate electronically whether by computer, tablet, or smart phone. At the same time the idea of privacy is both under attack and replaced by social media such as twitter and Facebook. “Though often upstaged by more advanced technologies, the basic use of e-mails between physicians and patients has systematically and culturally transformed the private, time-controlled space of this fundamental relationship” (Wieczorek, 2010, p 312).

Security is an issue for information on the Internet. Even the pentagon cannot completely defend its self from hackers stealing information. “The Pentagon was today bracing itself for a massive leak of as many as 500,000 Iraq war documents published on the controversial WikiLeaks website” (Associated Newspapers Ltd., 2010). The question is on whether personnel health information is worth stealing. The information in a personal health record with the social security number and in some instances credit card number can be valuable to an identify thief. An e-mail constructed for use between doctor and patient could contain such personnel information it is doubtful that it would. The information contained within an email between doctor and patient would most likely be simple questions and answers covering a topic already covered in person. Most doctors will request a patient presenting with symptoms make an in-person appointment because most states require a physical examination before prescribing medication.

Doctors are in business to make money. They do this by seeing and treating patients. Many of patient visits come down to advice, so expert medical advice is a revenue stream for doctors. By giving advice or a consultation by way of e-mail the doctor is losing money and time out of his or her busy practice. Out of the two time it the most important. Time spent on a free consultation is time that could be making profits for the practice. “There are a number of significant advantages associated with the use of email as a means of communication between surgeon and patient” (Ketteridge, Delbridge, & Delbridge, 2005). A way for a doctor to do a successful e-mail consultation practice would be to charge for answers either with a credit card on file or using an e-mail service developed and operated by the practice. Several practices could use this service to their advantage while pulling their funds together for security and functionality.

HIPAA requires doctors to do their best to protect health information on patients.

To help prevent a problem with HIPAA it would be prudent to use a service provider is HIPAA complainant. One way to comply is to use a service that is approved of by the government and setup to follow the rules set by HIPAA. This includes encrypting e-mails and backing up any correspondence. The new regulations for HIPAA passed for 2010 essentially make most commonly used e-mail service providers unusable for health information. “The HIPAA Technical Safeguards cover the particular means by which to secure ePHI, with the most important requirement that email messages be encrypted and protected during the entire time they are transmitted across the Internet” (Lux Scientiae®, Incorporated, 2011). This service would also have to include a way to provide both log-in names and passwords for both the doctor and the patient to prevent the most common mistakes done by people in creating passwords. Most people will either use the same password for all files or some bit of information that can be obtained by using the Internet or a social media site such as Facebook. “Today, in the era of widespread Internet use, an attacker can easily find answers to many security questions” (Zhang, , & Dayarathn, p. 33 2010).

The potential benefits of e-mail and the commonality it has with the public has the public ready and willing to use e-mail to communicate with their doctors. The Internet is not a 100% secure environment. A doctor or patient can do everything to protect their information, but if a hacker wants it no one is safe. Even the Pentagon cannot protect themselves. Security will always be an issue, but it should not be a deterrent to the practicality that E-mail provides. Doctors and patients can do practice measures in protecting their information from passwords not commonly used to physicians using programs designed to protect information and is HIPAA compliant.

Associated Newspapers Ltd. (2010) Pentagon prepares for largest security breach in U.S

military history as WikiLeaks set to release 500,000 Iraq documents. Retrieved from http://www.dailymail.co.uk/news/article-1321398/WikiLeaks-release-500k-Iraq-documents-US-militarys-largest-security-breach.html

Ketteridge, G., Delbridge, H., & Delbridge, L. (2005, Aug). How effective is email

communication for patients requiring elective surgery?. ANZ Journal of Surgery, 75(8), 680-683. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=f340d750-1390-4176-bab6-8da7a89fd127%40sessionmgr14&vid=8&hid=2

Lux Scientiae®, Incorporated. (2011). HIPAA HITECH 2010: Email Hosting at LuxSci.

Retrieved from http://luxsci.com/extranet/pdf/LuxSci_HIPAA_HITECH_Overview.pdf

Wieczorek, S. (2010, July). FROM TELEGRAPH TO E-MAIL: PRESERVING THE

DOCTOR-PATIENT RELATIONSHIP IN A HIGH-TECH ENVIRONMENT.. ETC: A Review of General Semantics, 67(3), 311-327. Retrieved from http://ehis.ebscohost.com/eds/detail?vid=28&hid=124&sid=0f6834e2-e463-4425-b20b-01044e0b60c1%40sessionmgr4&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=f5h&AN=57264785

Zhang, F., & Dayarathn, R. (2010) Is Your Email Box Safe?. Journal of Information Privacy &

Security, 6(1), 28-52. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=0f6834e2-e463-4425-b20b-01044e0b60c1%40sessionmgr4&vid=16&hid=2