Issue link: http://viewer.e-digitaledition.com/i/290262
"E LECTRONIC COMMUNICA- TION HAS many advantages, such as saving patients time, improving access to care, and in some cases, providing higher quality care," says Tara F. Bishop, MD, MPH, Assistant Professor in the Department of Public Health and Medicine, Director of Quality Improvement Operations in the Department of Medicine, and Research Mission Director for the Division of General Internal Medicine at Weill Cornell Medical College. "But physicians and practices need to be prepared for more work and should consider ways to reduce the number of offi ce visits or decide who else on the medical team can manage electronic communication." Dr. Bishop led a study published in the August 2013 issue of Health Affairs that followed the current use of elec- tronic communication in 21 medical groups, interviewing staff members at six practices. Overall, Dr. Bishop and her team found that electronic com- munication was a safe, effective way to support more patient-centered care, but many practices are strug- gling to incorporate it. On average, Dr. Bishop found, providers received anywhere from fi ve to 50 emails per day, which became challenging for some to answer in a timely manner when added to an already packed schedule. Tips for Success W hen building in time to ma n- age electronic communication with patients, physicians should recognize t hat needs va r y ba sed on patients' requests or concerns. Follow these Dos and Don'ts to get off on the right foot. + DO clarify with patients when they can expect an answer. A recent report published in Quality Management in Health Care led by Mayo Clinic research- ers found that on average, weekday electronic messages were opened within 12 hours, whereas messages sent on weekends were left unopened for 36 hours. Adding a caveat that all electric communications will be read and answered within 48 hours can set expectations for patients. A note that emergency situations warrant a 911 call or ER visit may also be needed. + DON'T get caught in a back-and-forth situation. Some questions call for a face-to-face visit. "Questions or concerns where you need to physically examine a patient, where you need to establish rapport, or where communication by email or secure messaging becomes too cumbersome are better suited for offi ce visits or simple phone calls," Dr. Bishop recommends. If a complex situation presents itself, it's appropriate to respond with a preference to see the patient in a clinical setting or have another staff member follow up with a phone call. + DO take a strong team approach. Allowing appropriate staff members to complete tasks such as scheduling follow-up visits or approving prescrip- tion refi lls can help physicians when they fi nd themselves in a time crunch. "Practices should consider teams to triage messages," says Dr. Bishop. "Nurse practitioners, physician assistants and nurses can often manage clinical issues that arrive electronically." ■ THE ROLE OF EMAIL Outside the Offi ce Visit: WITH ELECTRONIC HEALTH RECORDS BECOMING THE NEW NORM DUE TO GOVERNMENT REGULATIONS, PATIENTS HAVE MORE OPPORTUNITIES TO CONNECT WITH PHYSICIANS THROUGH SECURE ONLINE PORTALS THAT MEET HIPAA STANDARDS. BUT HOW THIS FORM OF COMMUNICATION SHOULD BE MANAGED IN A PRACTICE SETTING REMAINS MURKY FOR MANY PROVIDERS. By Rachel Stewart CORE ++++++++++++++++++++++++++++++ + +++ + +++ ++++++++++++++++++++++++++++++ PRACTICE MANAGEMENT 1 4 | Greater Kansas MD NEWS ■ M D N E W S . CO M