E-mail guidelines call for strict privacy safeguards
The American Health Information Management Association (AHIMA) in Chicago offers extensive guidelines for reducing the various risks associated with e-mail use in health care. These are some excerpts:
- Establish a policy and educate patients about appropriate types of e-mail (prescription refills, appointment scheduling, lab results) and queries that will not be responded to via e-mail (HIV, mental health).
- Electronically copy and paste e-mail addresses and/or use the reply button to minimize mistyped e-mail addresses.
- Answering e-mail messages from home requires the clinician to have a private e-mail address with privacy and security procedures in place.
- The clinician must not communicate with patients in the context of their professional relationship using personal e-mail accounts such as America Online, EarthLink, or any other nonemployer e-mail system.
- Requests from patients to discuss subject matter that is not appropriate for the electronic medium should be resolved via telephone or in person. The following topics should not be discussed in e-mail transactions:
— protected diagnosis (e.g., mental health, substance abuse);
— communication related to a diagnosis of HIV/AIDS;
— workers’ compensation injuries and disability;
— confusing or abnormal test results;
— new diagnoses;
— bad news;
— anything urgent. - When communicating confidential medical information via e-mail, a banner similar to the one below should be displayed prominently at the beginning of the e-mail message:
THIS CONFIDENTIAL COMMUNICATION CONTAINS INFORMATION PROTECTED BY PROVIDER-PATIENT PRIVILEGE.
- Develop and enforce policies defining and prohibiting emergency email messages.
- Use the signature line for all outgoing messages to communicate important guidelines and information, such as:
— physician’s full name and contact information;
— response time;
— instructions for when response time is not met;
— instructions for urgent communication and patient emergencies;
— other abbreviated guidelines as needed. - Web pages used as links or given to patients should reflect active links and credible web sites.
- The patient should initiate e-mail messages. Providers should respond to patients by using the reply button.
- Include the patient’s original message in any reply.
- The original e-mail, with reply, should be filed in the electronic record or printed for the paper record. The provider should initial and date the paper copy for the paper record.
- Develop policies and procedures for retention and storing (filing) e-mail messages in the paper medical record or electronic health record.
- Use e-mail system functionality (e.g., automatic reply to acknowledge receipt or notify senders that the physician is out of the office, return receipt to confirm patient receipt).
- Develop policies and procedures to guide the use of group e-mail messages. For example, patients should not see names of all intended receivers.
- A health care entity should have a standardized template for e-mail in place to ensure the appropriate information is communicated and captured.
- Lengthy e-mail messages or prolonged correspondence with a patient may necessitate scheduling an appointment with the patient or calling the patient.
- Establish a policy for e-mail turnaround time. It should include:
— priority for different types of messages.
— identification of what may require urgent, emergent handling;
— instructions for when the turnaround time is not met.
(For more of the AHIMA guidelines on e-mail, see http://library.ahima.org/xpedio/groups/public/documents/ahima/pub_bok1_022164.html.)
The American Health Information Management Association (AHIMA) in Chicago offers extensive guidelines for reducing the various risks associated with e-mail use in health care.Article Limit Reached
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