Patient-physician e-mail communication: the kaiser permanente experience

Kaiser Permanente (KP) is a not-for profit health care organization that provides care for approximately 8.7 million members in nine states and the District of Columbia. In 2004, it began implementation of its current electronic health record (EHR), which by 2010, was in use in all KP regions, in both outpatient and inpatient settings. Over the same period, a suite of online services was also implemented. Among these services was a password-protected e-mail system (referred to as secure messaging) that allowed physicians and patients to communicate electronically. Use of secure messaging has increased rapidly. By 2010, 64% of the 3.6 million KP members in northern California had signed up for online access. In 2010, the 7,000 physicians of Northern California KP received 5.8 million secure messages. Secure messaging has been associated with a decrease in office visits, an increase in measurable quality outcomes (at least in primary care), and excellent patient satisfaction.