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E-mail could be good for your patients' health

Online communication between doctors and patients can improve results, a study says. But observers say more research is needed to determine exactly how.

By Pamela Lewis Dolan — Posted July 29, 2010

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There is a strong link between patients' ability to e-mail physicians and improved patient outcomes, concludes a study conducted by Kaiser Permanente.

Kaiser retrospectively observed 35,423 patients with diabetes, hypertension or both in its Southern California region from February 2005 to December 2008. It found that within any two-month period, those patients who regularly communicated with their primary care physicians through Kaiser's secure messaging system saw significant improvements in their HEDIS care measurements.

Patients saw improvements ranging from 2.0 to 6.5 percentage points in cholesterol and glycemic screenings and blood pressure. Study authors say it's a result of patients becoming more empowered through communication.

The study, in the July issue of Health Affairs, found that patients initiated more than 85% of the 556,000 message threads, which contained a total of 630,807 actual messages. Physicians received between 2 to 12 messages per day and spent an average of 3.5 minutes responding to each message (link).

Physicians participating in the study said the electronic communication enabled patients to follow medical instructions better. They said they also were able to assess patients' medical needs to encourage them to come in for a visit when necessary.

While this study did not analyze the types of messages exchanged, a previous study of Kaiser's My Health Manager personal health record conducted in 2007 found that patients most commonly initiated contact with their physicians to discuss lab results, changes in health conditions and drug dosage or new prescription questions.

Jim Jirjis, MD, an internist at Vanderbilt University Medical Center, has been communicating electronically with patients for five years through a system similar to Kaiser's. He said the communication allows physicians to keep closer tabs on chronically ill patients, because it's more convenient for patients to stay in touch.

Devon Herrick, senior fellow at the National Center for Policy Analysis, said that although electronic communication with physicians can help patients, more experimentation is needed to form a consensus on how it could affect each type of patient. In a recent policy report Herrick co-authored, he examined various studies on using health information technology to improve health outcomes. He found conflicting results depending on the type of patient and the patient's condition, which he said can be attributed to differing levels of patient compliance, regardless of their Internet use.

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