email and patients

[Guest guest]

, Lou and anybody using email with patients,

spoke about using email to improve access on the conference call this

morning, which touched on an issue I am currently looking at... how to best

communicate with patients using email.

I think many doctors include a disclaimer in their emails, or have patients

sign a " release " when they join the practice authorizing email use and

explaining the security/confidentiality risks. My understanding of HIPAA,

is that it doesn't provide specifics on the technology that we use, only

that we have a policy describing what we do. Is that a fair assessment?

So... what are the true risks of email? My thoughts are that the server

that stores the content of emails and attachments is the largest security

issue. I am under the belief that an email being snatched up during

transmission is not a likely threat to security, but uncontrolled access to

the server would be ( for instance, gmail, hotmail, aol etc having records

of these communications).

So... what are the possible ways of securing email data? My first thought

is to bring this in house and actually host the email on our own office

server and hand out email accounts to patients. This allows us to have more

control of confidential materials and would make me more at ease

communicating test results as attachments or financial information for

billing purposes.

There are obvious drawbacks such as having to manage SPAM, forgetting

passwords, and containing viruses, but I assume there are solutions for each

of these problems as well.

Gordon mentioned that may know more about messaging systems that may

get around some of the security issues, and I would love to hear more about

these.

I understand that the medfusion sites offer a " portal " for patients to leave

messages and for doctors to check for them. This system uses the patient's

email to provide a " tap on the shoulder " to tell them to go and log on to

the website portal and check the message or result left there. I'm not so

thrilled with the cost for this service though.

I have more thoughts on this, but I'd like to open this up for discussion.

Who is using email and how? What works and what doesn't? What are your

security/confidentiality concerns?