Electronic Communication in Healthcare
HCS 533 ??“ Health Information Systems
March 21, 2011
Dr. Rob Rupnow
Electronic Communication in Healthcare
Healthcare in 2011 and beyond relies on electronic communication to improve interaction between patients and caregivers. Increasing numbers realize the potential of the Internet to integrate information about research, treatment, peer support, and diagnostics. Healthcare professionals access electronic communication for patient contact, to consult with other colleagues, and to locate information. Websites are available at the touch of a keyboard for insurance companies, healthcare facilities, and pharmaceutical companies.
To date, advancing technology for healthcare information is rapid. The speed of technology in healthcare delivery is not. The ability for patients to communicate directly with physicians allows the practice of medicine increased efficiency that leads to increased cost effectiveness. Electronic interaction has the potential to lower the expense of in-person service, permit immediate access to information, promote convenience, and reduce the experience of unclear education in stressful situations.
External Delivery Sources
The California HealthCare Foundation conducted a survey in 2006 that stated 77% of patients want to interact with their doctors online. It also stated that 85% of physicians polled want to use the Internet to streamline their practices, and 99% of all providers view the use of the Internet as a way to gain competitive advantage (Electronic Healthcare Communication, 2008).
Internet e-mail is the most common was to interact electronically. Medical facilities currently use e-mail to schedule appointments, refill prescriptions, conduct patient satisfaction surveys, educate clients, and transfer information concerning diagnostic testing.
Other forms of electronic communication not as commonly used as email include Personal Data Applications (PDA) text messaging, video conferencing and consulting, digital telephony, and healthcare 2.0 platforms.
Improvements in patient interaction, care, and safety result with the use of electronic communication in healthcare.
The efficiency of healthcare facilities decreases with interruptive telephone calls, office visits that are not essential, and telephone conversations with communication problems. Use of the telephone requires the ability to listen and comprehend the information. Information sought by one or both parties may not be available. Confidentiality is difficult to keep over the telephone. Messaging systems run out of time for an extensive message. The use of e-mail allows both parties to read and respond to the message when it is convenient to do so. E-mail use has unlimited space for a message. It also allows attachments for including documents and website links.
Electronic communication has the advantage of automatically documenting all correspondence for future reference. A patient can review instructions and information. The patient can examine laboratory results and formulate questions without the pressure of time constraints. The use of traditional telephone conversations, written instructions, potentially confusing information, and time-consuming personal visits do not encourage review and retention.
E-mail communication between patients and providers allows cost savings in terms of decreased staff salaries, reduction in repetitious actions, less review of information, and retention of past communication. A patient with the ability to review at home or with individuals who can help with translation, either conceptually or through language assistance, prevents the need for office staff and physicians to repeat instruction, education, or requesting copies of results again. Electronic communications also allows convenience, permitting staff to prioritize tasks and patients to have time to analyze information and formulated questions.
Provides precise records
Conversations in person or unrecorded telephone calls do not allow a precise record of the communication. E-mail allows retention of all communications for all parties, a benefit both for business accuracy and legal liability. The elimination of inaccurate interpretation, faulty memory, or poor retention is accomplished with the addition to electronic medical records of all patient and caregiver interactions.
Barriers to Implementation and Solutions
Barriers to the development of electronic communication in health care exist. They involve the same types of concerns presently accompanying paper-based and oral communication, but address the medium of the Internet.
Safeguards are in place to protect electronic health information, but the perception of the lack of security impedes its use. In addition to technological solutions, such as passwords and lock out systems, the adoption of formal policies within the workplace and a cultivation of cultural habits promote a feeling by users that their health information is private. Errors in entering e-mail addresses occur and e-mails allow interception. Patient identity is difficult to establish. Word documents sent as attachments remaining on a hard drive present a confidentiality risk. The use of private personal computers presents chances for interception. Viruses attached to e-mail cause considerable damage.
Legal complications from confidentiality infractions and allegations of malpractice are a consideration; these considerations are the two major deterrents to physician use of e-mail communication with patients (Suarez, 2001). To address these concerns, the American Medical Association recommended guidelines for Internet use. These guidelines included:
??? Definition of patient-physician communication
??? Content. Includes tone, acceptable topics, standard items for discussion, etc.
??? Practices and policies concerning informed consent, storage of communications, responses, reception of information, and access.
??? Technical and security related to authentication, privacy, and encryption
??? Financial reimbursement for electronic communication
??? Legal issues related to federal or state laws regulating electronic communication (Suarez, 2001)
Changes in the capabilities of electronic communication help drive healthcare toward its use. Changes also point to the possibility that many organizations will find it difficult to stay current. Information systems need the ability to interact with legacy databases, to find dynamic websites, to contain strong browsers, and to search engine technologies (Cain, 1999). Weaknesses in these areas create avoidance by heath care providers to use electronic communications.
An advantage to using the Internet for consultation and research; conversely, not all information on the Internet is reliable. Healthcare organizations need the ability to ascertain whether the information provided by a website is accurate. The mixed quality of data available prevents complete confidence of patients and physicians alike.
Incompatible Health Care Information Systems
Existing health care systems cannot always be used with the Internet. Physicians, healthcare facilities, insurers, and patients face the possibility of requiring system restructuring before interaction can occur. Many departments in health care organizations for information systems are not oriented to the Internet. Designers of web pages, engineers, technicians, and educators are necessary for system incorporation, and budgets require inclusion of these expenses.
. In the area of Medicare reimbursement, electronic communication lacks the ability to meet the requirements for documentation (AHIMA, 2003). Some third-party payers acquired the ability to process claims in come instances; this process has allowed improvement in workflow and cost outlay. In the event provider-patient communication improves electronically, it is likely use will increase.
Consumer use of the Internet to research information and to self-direct care will move more quickly than use by health care professionals. Patients will look to websites for ratings and purchases as well as recommendations. Support groups with focus on specific diseases are accessible to isolated patients. Doctors can experience a sense of loss of control over care because of Internet use by patients. Medical journals and continuing medical education will go to Internet access, increasing physician confidence. Consumer pressure encourages physicians to overcome fears associated with electronic messaging.
Use of the Internet will replace existing information systems within health care organizations. The justification is largely cost; once clarification of security regulations takes place, large claim clearinghouses will move to electronic communications. It is thought that other health care transactions such as enrollment, eligibility rulings, and reviews will move less quickly. Health plans are exploring ways to pay physicians through the Internet. As consumers demand lower health care costs, health plans also reduce paperwork and transaction times to manage administrative overhead. Health plans are also focusing on disease management programs for patients with chronic illnesses. The Centers for Disease Control and Prevention states the expenses for this group account for more than 75% of the $1.4 trillion spent every year in the United States (Fell, 2011).
As electronic medical records (EMR) become more prevalent in the industry, predictions are that activity in web-based front ends will increase. Full EMR should have the capability to provide decision support these cannot. Encrypted consultations between physicians can include digital photos and radiographs. Health plans such as BlueCross BlueShield of Tennessee are directing the move to online health records to improve patient care, lower costs, and prevent system abuse and fraud (Fell, 2011).
Government influence expands with awarding grants to physicians with new legislation. Funding is available for programs implementing electronic prescribing and pay-for-performance pilot initiatives (Fell, 2011).
Electronic communications within the healthcare industry depends on a design allowing usability characterization and appropriate methodology. Special concerns and risks accompany the traditional legal, ethical, and professional guidelines of more traditional communication. Interaction between doctors and patients alters with the use of Internet messaging, and health plans serving both clients take advantage of the channel to conduct business. Progressive health care providers continue to find ways to maneuver the problems and technology of electronic communication. Indications at this time are that lowered costs and improved patient care will be the winning result.
American Health Information Management Association. (2003). AHIMA. Retrieved from
Cain, M. (1999). Infomatics Review. Dean F. Sittig. Retrieved from
Electronic Healthcare Communication. (2008). Clinifowiki. Retrieved from http://
Fell, D. (2011). Strategic healthcare Communications . Health Care Communications.
Retrieved from http://www.strategichealthcare.com/pubs/ehealth/f1_
Suarez, P. (2001). Texas medical Association. Texas medical Association. Retrieved