Future Trends in Electronic Health Care Communication

Introduction

Direct communication with patients remains an obstacle in the quest for an effective patient-physician relationship. Nevertheless, electronic communication with clients via websites, telephone, and email has forced physicians to re-engineer their strategies for caring for patients. Access to online wellness and health information, home-based monitoring systems, online medical services, and web-based support teams has enabled patients to embrace added responsibilities for their own health care.

This paper examines how the Internet and other forms of electronic communication may be used as an external delivery source for communicating patient-specific information. It also explores how distance delivery affects health care, including the use of emails, telemedicine, and the electronic transfer of records in service delivery (Latifi, 2008).

The Use of Email, Telemedicine, and Electronic Records

For many years, physicians have used telephone services to pass messages to patients. In administrative terms, they have used the telephone when scheduling appointments, reminding patients about appointments, relaying lab results, and handling requests to renew prescriptions. Additionally, healthcare providers make a host of administrative phone calls to pharmacies, hospitals, and insurance companies (Fleisher & Dechene, 2010).

Physicians can also use the telephone as a clinical tool. When dealing with established patients such as those with chronic diseases, the telephone can save both money and time, reducing heavy office schedules. Care providers can use the telephone to offer clinical advice, monitor the impact of treatment, and discuss patient results. Determining the level at which clinical services can be offered via telephone — in the absence of tactile and visual information that patients provide in person — is challenging. For physicians to make such decisions, they must carefully study the legal and clinical factors underlying the competence and scope of basic guidelines. In any decision they reach, physicians must always document the patient's health record (Latifi, Poropatich & Hadeed, 2011).

With the increasing volume and role of telephone calls, a wide range of practices has adopted innovative technologies to enhance convenience and efficiency for patients, physicians, and office staff. In some practices, automated telephone systems have been adopted, providing patients with a set of options that direct them to the appropriate staff member (Spekowius & Wendler, 2007). In addition, automated outgoing calls have been incorporated to remind patients about upcoming appointments or to notify them of lab results. Many physicians now use wireless phones to maintain contact with staff members and patients while out of the office. This mode of instantaneous communication benefits patients but requires physicians to invest extra effort in performing follow-ups and documenting all information. A lack of established boundaries on the physician's side may expose them to potential overuse by patients, since no clear parameters exist for families and patients regarding calling habits.

The telephone also has limitations and is ineffective when critical information must be conveyed. Communicating with patients about sensitive lab results or potential problems over the telephone can be disruptive and time-consuming. While patients appreciate when physicians call, this may not always be the best approach for the operation of the practice. Conversations over the telephone tend to be synchronous, meaning that communicators must interact simultaneously (Demiris, 2008).

When simultaneous communication is not possible, telephone users tend to leave messages for each other, often leading to a cycle of missed calls and callbacks. Although synchronous communication is best for urgent and time-sensitive matters, it is not always necessary. Telephone conversations require appropriate documentation in patients' medical records, which adds to the physician's workload. Physicians have a tendency to skip this step, which can result in malpractice issues. Additionally, real-time phone calls can be rushed. Studies of office visits have shown that patients remember only about half of what physicians tell them over the phone, leading to reduced quality of care and patient frustration. Physicians are therefore encouraged to reduce unnecessary calls to patients and to document all telephone conversations in health records. The Internet presents itself as a promising solution to these shortcomings (Lecca, Valentine & Lyons, 2010).

As more patients and physicians become aware of electronic communication methods, the desire to apply them to ambulatory care has gained significant momentum. Surveys indicate that online medical communications with patients have grown in popularity. For instance, eighty-four percent of U.S. citizens have accessed online infrastructures to obtain medical information. Over ninety percent of American adults have gone online, with a growing interest in communicating with physicians digitally. Key advantages include enhanced efficiency in service delivery, shortened patient service times, and reduced office visits (Fleisher & Dechene, 2010).

Strong Demand for Online Patient Care

Electronic delivery of non-urgent medical care offers various benefits for both physicians and patients.

Benefits of Electronic Healthcare

Web-based patient communication increases the productivity and efficiency of a practice through fewer telephone calls, reduced administrative costs, and the attraction of additional clients. Email exchanges tend to be less disruptive than phone calls; physicians can address them at their own convenience, and the exchanges are self-documenting. Many communications previously conducted face-to-face or by telephone — including prescription renewals, patient scheduling, patient monitoring, and quick medical questions from patients with chronic illness — are now being handled through Internet-based channels. Internet-based technology is also offering disease management tools such as data transmission from electronic home-based monitoring systems, which are cheaper and more accessible than traditional paper-based systems (Spekowius & Wendler, 2007).

Surveys have shown that thirty percent of the approximately 900 million annual office visits could be eliminated through patient-physician online communication. Online care provision enables physicians to monitor patients and provide follow-up services without requiring an office visit. This allows physicians to spend more quality time with seriously ill patients and helps other patients avoid unnecessary trips to the office.

Patients can save time when they obtain vital clinical information before making an office visit, making the direct patient-physician encounter more productive. This can translate into shorter waiting times, less-crowded waiting rooms, and greater patient satisfaction. Through online communication, it can be more convenient for patients to reach physicians than through telephone appointments and messages, further contributing to patient satisfaction (Spekowius & Wendler, 2007).

Patient-physician communication through online networks is efficient in part because of its asynchronous nature. Physicians can take time to craft thoughtful responses to patient questions and communicate at the most convenient time for them. Similarly, patients can read messages as many times as they wish, at their own convenience, and can share the information with family members or friends. This leads to increased satisfaction and better information retention (Ginzberg & Minogiannis, 2007).

Electronic communication also makes supplementary information easy to provide. Physicians can include reliable links to web-based resources on various healthcare topics and attach documents explaining different conditions in greater detail. Some healthcare systems have incorporated customized responses to frequently asked patient questions, giving patients the opportunity to learn about different health conditions. However, this does require physicians to invest significant time in preparing such information. When physicians are readily available to patients online, patients develop a stronger connection with their physicians, leading to increased retention and satisfaction (Saranummi, 2009).

Conclusion

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Latifi, R., Poropatich, R., & Hadeed, G. J. (2011). Telemedicine for trauma, emergencies, and disaster management. Boston: Artech House.

Lecca, P. J., Valentine, P., & Lyons, K. J. (2010). Allied health: Practice issues and trends in the new millennium. New York: Haworth Press.

Saranummi, N. (2009). Regional health economies and ICT services: The PICNIC experience. Amsterdam: IOS.

Spekowius, G., & Wendler, T. (2007). Advances in healthcare technology: Shaping the future of medical care. Dordrecht: Springer.