Docs Balk, But Email Improves Patient Experience

I hate calling my doctor's office. I like my doctor, and I like her office staff, but calling is the worst.

It's a busy practice, so I often wait on ho ld for a few minutes before reaching a nurse who is not assigned to my physician. The appropriate nurse usually returns my call within the next hour or so, but by that point I don't even care about getting clarification on my lab results anymore.

Worse than calling my doctor's office is when the office calls me.

I don't answer my cellphone unless I recognize the exact number (and in case you think I'm in the minority here, not a one of my friends does either). And I keep my cellphone on silent while at work. These practices unfortunately result in a wonderful game of phone tag that only succeeds in leaving everyone frustrated and me wishing my doctor could just tweet my lab results at me, HIPAA be damned.

You can imagine my delight, then, when my doctor's practice enabled the email function on its patient portal. Now not only can I view my lab results, but also send a follow-up email in all of about 40 seconds. My doctor typically replies within a few hours and I don't mind the wait because I'm busy doing other things in the meantime, versus waiting on hold or staring at my phone.

Physicians Slow to Adopt Email
It is no wonder patients love the ability to email their PCP with minor questions—for clarification (like me) or to request forms or prescription refills. Unfortunately, most doctors approach communicating electronically with patients with trepidation.

Less than one-third of doctors reported emailing with patients in 2012, up from 27% in 2008, according to annual studies of more than 3,000 doctors conducted by Manhattan Research. That's right, the number of physicians emailing with their patients increased by only 5 percentage points in as many years. To put that in perspective, Twitter went from a tiny start-up to a multi-billion dollar company in the same amount of time.

Furthermore, physicians who texted via SMS messages with patients about their care increased from 12% in 2010 to 18% in 2012.

Only 5.5% of 30,000-plus Americans included in a National Health Interview Survey reported communicating with a healthcare provider by email in 2011, up slightly from 4.6% in 2009, the Wall Street Journal reports.

Benefits of Email
These statistics are, frankly, pathetic and it's the marketer's job to improve them. Beyond creating more engaged patients and potentially improving quality of care, patient emails are at heart a communications issue. It's a workflow/efficiency issue. Think of all the time that's wasted when doctors' offices and patients play phone tag. And—more than that—it's a patient experience issue. Patient experience extends far beyond the bricks and motor of your hospital.

When I sit on hold, talk to a nurse, and wait an hour for my doctor to call me back, that is a negative patient experience.

When I email my doctor and receive a quick and informative reply that I can forever reference in the archive of my patient portal that is a positive experience.

A Prominent Detractor
It won't be an easy job for marketers to enact this drastic culture change, and physicians do have many legitimate concerns. In a candid blog post, Kevin Pho (a.k.a. Kevin MD) explains why he emailed with patients for two years before abandoning the practice, presumably never to start again.

"For sure, most patients loved using email," he writes. "The option to report any symptom or concern at any time of the day without having to bother with telephone menu prompts or dealing with the hassles of making appointments proved to be tremendously convenient. And for those questions that were straightforward and consisted of hardly two sentences at most, email at times was a definite time saver."

Two issues, however, concerned Pho enough that he ceased emailing with patients for good:

1. Some patients either wrote unclear emails or misinterpreted his response, leading to confusion and complications.
2. He worried that a diagnosis could be missed whenever an office visit was replaced with email communication.

These are both valid points marketers should consider when moving forward with any doctor-patient email plan. But unlike Pho, I believe the adoption of communicating with patients about their care over email is unavoidable, so it's in a provider's interest to move forward as best as possible.

Perhaps one way to prevent superfluous or confusing emails is to create guidelines to set expectations for both patients and physicians. At the outset, perhaps instruct patients to only email their physician when they are seeking clarification or asking a minor question. For example, "Is it okay to get a flu shot while pregnant?" versus "My chest has felt tight lately, what should I do?"

Patients and physicians should understand that email must never be used for diagnosing symptoms. And, of course, doctors should be empowered to tell patients to schedule an appointment if they are using email incorrectly or excessively.

It won't be an easy road ahead, for marketers or physicians, but healthcare can't continue to lag behind other industries in using email to communicate with its customers.

Remember what happened to Blockbuster when it refused to upload streaming movies online? Make sure your organization is the Netflix of this metaphor.