Chances are your doctor is less likely to use email than you'd like. That’s the upshot of new research that shows electronic communications in clinical care aren't likely not be widely adopted by primary care physicians until patient workloads are reduced or they are paid for the time they spend phoning and emailing patients during and after office hours.

 

The study, by investigators at Weill Cornell Medical College, tracked six medical practices that routinely use electronic communication for clinical purposes. The findings, published in the journal Health Affairs, indicate many physicians feel e-consults create more work for providers and lack of payment for them is a significant deterrent.

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"Leaders of medical groups that use electronic communication find it to be efficient and effective — they say it improves patient satisfaction and saves time for patients. But many physicians say that while it may help patients, it is a challenge for them," said lead researcher Tara F. Bishop, M.D., an assistant professor in the Department of Public Health and Medicine at Weill Cornell Medical College.
 

"One leader said that the work never ends. It takes a psychological toll on some people — the feeling of never being done. Another said that in one day, he sometimes sees 10 patients face-to-face but communicates with another 50, commenting that he works all the time. One leader told us that insurance companies said that if physicians are doing it for free, why should we pay for it?"
 

The push for electronic communications has been widely endorsed as a means to improve quality of care by, for example, emailing test results to patients, or managing clinical conditions without requiring a time-consuming and costly office visit. Still, few physicians use it. By 2008, the latest year for which figures are available, less than 7 percent of physicians regularly communicated with their patients electronically.
 

But Dr. Bishop noted pressure from patients may ultimately force physicians to communicate with their patients via electronic health records or secure email.
 

"I think there are ways to make a transition to electronic communications in health care work," she said. "Our study offers some good examples, but I still think we have a long way to go before physicians routinely email their patients."