A significant discrepancy exists between patients' desire and their actual use of online communication tools to communicate with their physicians, according to a new study.
Despite patient interest in using e-communication to reach their caregivers—be it through email, Facebook, or an electronic health record system—few patients actually use these technologies. A quantitative study addressing this discrepancy—the result of a collaboration between CVS Health, the Johns Hopkins University Bloomberg School of Public Health at Johns Hopkins University, and Brigham and Young Women’s Hospital and Harvard Medical School—was published earlier this week in the Journal of General Internal Medicine.
With funding from CVS, researchers delivered an online survey to over 2,000 CVS retail pharmacy customers during the spring of 2013. The survey inquired about patient communication preferences, specifically related to the use of online communication tools.
Dr. Facebook is in
Of those patients surveyed, 37 percent reported contacting their physician via email during the prior six months. Eighteen percent had contacted their doctors using Facebook. The authors note the significance of the Facebook finding, as many organizations warn against or prohibit social physicians from using social media to communicate with their patients.
Perhaps most significant, the survey results reveal substantial differences between the level of patient interest in online communication with their physicians and the actual rate of usage. Although 46 percent of patients reported an interest in using email to fill prescriptions, only 7 percent did. Similarly, 46 percent of patients were interested in using email or Facebook to access health information, but only 4-5 percent actually did. Fifty-seven percent of patients reported interest in using their physician’s website to access health information, but only 7% did.
Convenience before privacy
Patients aren’t as worried about their privacy or data security. Although these are significant issues for physicians and medical institutions, they were not valued as much as convenience and easy access. In fact, many patients preferred email to contacting their physicians through secured-portals, as having multiple passwords that change frequently are a pain point.
"The medical establishment needs to figure out how best to incorporate this reality into their practice while properly ensuring security safeguards," says study leader Joy Lee, Ph.D., M.S., a post-doctoral fellow in the Department of Health Policy and Management at the Bloomberg School.
This is an area where there is significant patient interest, but institutions and health care providers haven't caught up.
The study revealed other themes related to patient use of electronic communication tools as well.
- Patients with chronic conditions and their caregivers were more likely to use email or Facebook to contact their physician than those without chronic conditions.
- Non-white respondents were significantly more likely to use e-communication to contact their physicians.
- Lower education attainment reduced the likelihood that a patient might email the doctor, but this relationship wasn’t as consistent when it came to Facebook
A note of caution about this study: the results aren’t really generalizable for more than one reason. First, using only CVS customers could skew the participant sample. Second, the use of an Internet survey to discuss Internet issues might not reflect the opinions of non-Internet users.
The trouble with guidelines
The article's authors suggest that at least part of the discrepancy between patients’ desire to communicate with their physicians on electronic media and their actual use of electronic media for that purpose is due to the prohibitive social media guidelines of many hospitals and physician organizations. A few months ago I wrote about how difficult it can be for physicians to parse out what they can do for patients when the guidelines only tell them what not to do.
"If governing bodies establish prohibitive policies about what physicians cannot do – without addressing what they can do – many end up doing nothing at all." – see Pediatricians Walk the Social Media Tightrope by Jenn Lonzer.
As physicians shuffle to keep up with emerging technologies, caution about patient safety seems to take precedence over patient preferences. After all, they do vow to do no harm. However, with the potential for misinformation just a few key strokes away, it seems high time that we find a way to facilitate patient and physician communication that is both convenient and safe.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.