Doc-patient e-mail guidelines released

February 1, 2003

Pharmaceutical Representative

The eRisk Working Group for Healthcare has announced new guidelines for physician-patient e-mail.

To address the liability, payment and security issues raised by the increase in electronic communications, the San Francisco-based eRisk Working Group for Healthcare has announced new guidelines for physician-patient e-mail.

"The frequency of online doctor-patient and doctor-doctor communications is growing, and precautions must be taken to ensure that physicians utilize secure e-mail with patients, and that they offer patients high-quality clinical information," said Joe Heyman, an obstetrician-gynecologist and representative of the Chicago-based American Medical Association.

Know the patient first

The guidelines from the working group, a consortium that includes the AMA and other leading national medical societies and liability carriers, mandate that substantive patient-physician e-mail occur solely within the context of a pre-existing relationship. This particular guideline is a reaction to the fact that states have recently taken action against online services in which physicians provide online care and prescribe medication for patients they have never seen.

Other guidelines for communicating with patients online include a warning against active solicitation of emergency topics (for example, chest pain, shortness of breath, bleeding) or active solicitation of highly sensitive information. The new guidelines reemphasize the need for compliance with the Health Insurance Portability and Accountability Act and use of secure online messaging, with authentication and encryption, as opposed to standard e-mail, for physician office communications. The group has also developed detailed terms of service and informed consent language that educate patients as to the appropriate use of online communication in healthcare, while providing additional liability protection for physicians.

"While increased documentation provided by secure e-mail with patients can be a positive, the new eRisk guidelines make it clear to physicians that there are risks in communicating outside of pre-existing patient-physician relationships, and in using standard, unencrypted e-mail to communicate with patients, or to transmit patient information to third parties," said Mark Gorney, medical director for the Napa, CA-based Doctors' Company, a national malpractice carrier. "Given these risks and the HIPAA regulations, it makes good sense to follow the eRisk guidelines when physicians communicate online." PR

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