Pandora's electronic box: GPs reflect upon email communication with their patients

Global access to information technology has increased dramatically in the past decade, with electronic health care changing medical practice. One example for general practitioners (GPs) is communication with patients via electronic mail (email). GPs face issues regarding e-communication with patients, including how and when it should it be used.

The study aims were to assess the extent that GPs communicate with patients by email and explore their attitudes to this mode of communication.

Design--telephone interview survey. Setting--primary care, largest urban and suburban area in New Zealand (NZ). Subjects--randomly selected GPs from the Auckland region. Main outcome measure--description of email use; analysis of issues by telephone survey. Data analysed using SPSS-12 and by thematic content analysis.

At data saturation, 80 GPs had been interviewed. The majority (68%) had not used email with patients. Only 4% used it regularly. However, there was strong interest in this method. Perceived advantages were the ability to communicate at a distance and time convenient to both doctor and patient; communication where disability affected traditional methods; information-giving (for example, web links); passing on normal results. Identified problems involved inequity of access; linking of electronic data; security; unsuitability for some topics; medico-legal concerns; time; remuneration.

Study sample closely mirrored current NZ GP population. Although few GPs emailed with patients, many might once barriers are addressed. GPs had a collective view of the appropriate boundaries for email communication, routine tasks and the transmission of information. GPs would encourage professional debate regarding guidelines for good practice, managing demand and remuneration.