The Nature of E-Mail
E-mail is a hybrid between letter writing and the spoken word. It is more spontaneous than letter writing and offers more permanence than oral conversations. Words in e-mail can be more carefully chosen than in telephone conversation. While unencrypted electronic messages may, in theory, provide less privacy than postal mail or telephone calls, in practice e-mail replaces and is used more like the telephone but with less urgency. Because of its asynchronous nature (volleying back and forth over hours or days), e-mail helps prevent “telephone tag” and avoids the interruptions associated with telephone calls or electronic pages.
E-mail follow-up allows retention and clarification of advice provided in clinic. Often patients under the duress of illness forget to ask important questions. Selfcare instructions might not be fully understood or retained. E-mail creates a written record that removes doubt as to what information was conveyed.
E-mail is especially useful for information the patient would have to commit to writing if it were given orally. Examples include addresses and telephone numbers of other facilities to which the patient is referred; test results with interpretation and advice; instructions on how to take medications or apply dressings; pre- and postoperative instructions; and other forms of patient education. Some frequently used educational handouts can be ported to an e-mailer template or formatted for the provider's home page on the World Wide Web.
E-mail messages can embed links to educational materials and other resources on the clinic's Web site or on external sites. In some electronic mail applications, clicking on a “live” universal resource locator (URL) link inside a mail message launches a web browser and takes the user directly to the indicated resource. Clinics can provide lists of URLs on a particular topic, such as pregnancy, and create e-mail reply templates with pointers to frequently used reference sites.
While telephone messages are often overlooked, forgotten, or lost under piles of charts, e-mail messages are less likely to accidentally fall through the cracks of a busy practice. Voice mail systems can be plagued with irksome branching menus, lapses on hold, and the threat of telephone tag. Many callers hang up in frustration. With or without annoying automated systems, telephone messages are typically relayed along the “sneakernet”—a physical chain of human transmission from receptionist, to nurse, to doctor—with many “While you were out...” slips lost in the process.
In contrast with telephone conversations, e-mail is self-documenting: Copies of e-mail can be printed or attached to the patient's electronic record.
Finally, since many malpractice claims can be traced to faulty communication, good communication is part of good insurance.