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All of our doctors contact us through email. I think they use Epic, and we get all of our test results, appointment reminders, etc. there. With health care regu

All of our doctors contact us through email. I think they use Epic, and we get all of our test results, appointment reminders, etc. there. With health care regulations forcing electronic records, we'll probably see more of this.

patio11 12y ago
It's tricky with HIPAA, given that emailing almost anything interesting is a violation, since they can't control whether your email provider discloses it or not. The right way to do it is to email people and inform them that a secure system has Very Important Information for them and that they should sign in using pre-arranged credentials to check it. Even that email can be a HIPAA violation if you do it wrong -- for example, "Hiya Jane Smith, Dr. Foo OBGYN has important information for you" has been held to be a violation since Foo should have reasonably anticipated that some patients would be living with family and sharing email with them and disclosing a non-minor's pregnancy/etc to their parents without their consent is a per se violation. Ditto putting similar information into voicemails / SMSes / etc. Technical violations of the rules are rampant and enforcement actions are comparatively rare, particularly at smaller medical providers.
- r00fus 12y ago
  Well that's one nuance - another against voicemail for Doctors is that if you truly have an emergency, then it's possible practitioners are liable if you suffer while leaving a voicemail (or as a result of no one listening to that voicemail in time). Consequently, none of my doctors have a voicemail, so I'm forced to use their app to communicate with them, even if I just want a "you and/or kids are probably ok, come in if things get worse" confirmation. Very few have an "answering service" that has a real person transcribe and page the doctor (and advise you call 911 if it sounds like an emergency) but I imagine this is too expensive for most.
IgorPartola 12y ago
You cannot use straight email to communicate patient info. You have to send them a link to a site behind a login, which is a barrier to adoption. Even if that's OK, just sending an email to someone from, say, a psych clinic would expose them as a patient, which is not good either. You also cannot really indicate urgency. There is a difference between appointment reminders and "hey, your test came back positive". There are also some things that you prefer to discuss as you may have follow up questions. If your doctor calls you to tell you that you have HIV or cancer, you are going to ask questions. You don't want to get that news via SMS or email. Basically, routine reminders and test results are fine over a secure site with email notifications, but for lots of other things email is less than appropriate.

patio11 12y ago

It's tricky with HIPAA, given that emailing almost anything interesting is a violation, since they can't control whether your email provider discloses it or not. The right way to do it is to email people and inform them that a secure system has Very Important Information for them and that they should sign in using pre-arranged credentials to check it. Even that email can be a HIPAA violation if you do it wrong -- for example, "Hiya Jane Smith, Dr. Foo OBGYN has important information for you" has been held to be a violation since Foo should have reasonably anticipated that some patients would be living with family and sharing email with them and disclosing a non-minor's pregnancy/etc to their parents without their consent is a per se violation. Ditto putting similar information into voicemails / SMSes / etc. Technical violations of the rules are rampant and enforcement actions are comparatively rare, particularly at smaller medical providers.

r00fus 12y ago
Well that's one nuance - another against voicemail for Doctors is that if you truly have an emergency, then it's possible practitioners are liable if you suffer while leaving a voicemail (or as a result of no one listening to that voicemail in time). Consequently, none of my doctors have a voicemail, so I'm forced to use their app to communicate with them, even if I just want a "you and/or kids are probably ok, come in if things get worse" confirmation. Very few have an "answering service" that has a real person transcribe and page the doctor (and advise you call 911 if it sounds like an emergency) but I imagine this is too expensive for most.

IgorPartola 12y ago

You cannot use straight email to communicate patient info. You have to send them a link to a site behind a login, which is a barrier to adoption. Even if that's OK, just sending an email to someone from, say, a psych clinic would expose them as a patient, which is not good either. You also cannot really indicate urgency. There is a difference between appointment reminders and "hey, your test came back positive". There are also some things that you prefer to discuss as you may have follow up questions. If your doctor calls you to tell you that you have HIV or cancer, you are going to ask questions. You don't want to get that news via SMS or email. Basically, routine reminders and test results are fine over a secure site with email notifications, but for lots of other things email is less than appropriate.