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You’ve got mail: what doctors need to know about using electronic communications in practice

17 Dec 2013

Doctors have been warned to be alert to limitations and risks involved in using information technology to communicate with patients and other practitioners.

The AMA said electronic communications technologies were an increasingly useful tool for doctors, enabling them to conduct consultations with patients unable to attend their practice, and to quickly and efficiently share information and discuss treatments with other physicians.

But it cautioned that medical practitioners needed to be careful in how they used these technologies, to ensure patient privacy was protected, that quality of care was not compromised, and that practitioners did not leave themselves unnecessarily exposed to medico-legal risks.

AMA Vice President Professor Geoffrey Dobb said communication technologies were increasingly being integrated into medical practice, and were potentially a valuable tool.

“Technology-based patient consultations can improve patient access to care and enhance efficiency in medical practice,” Professor Dobb said, adding that the ability of doctors to share information electronically could be of great benefit, particularly in coordinating care.

But he said doctors needed to aware of limits to the uses of such technologies, and the risks that they entailed.

“Technology-based patient consultations should complement face-to-face consultations, not replace them,” Professor Dobb said. “They should be used as an adjunct to normal medical practice for regular patients of the practice, and they should not be used in a way that fragments the ongoing care of the patient.”

Similarly, he warned, doctors needed to be aware of, and manage, the inherent risks involved in receiving and managing large amounts of information electronically.

The AMA has prepared two guides, a Position Statement on technology-based patient consultations 2013 and a Position Statement on medical practitioner responsibilities with electronic communication of clinical information 2013 setting out the issues doctors need to consider in using such technologies, as well as practical advice on how to make the most of these tools while minimising the risks involved.

In conducting a consultation via the internet or another form of communications technology, doctors needed to be confident that it is being conducted in a private and secure setting, and that the patient is properly identified, and understands and agrees to the arrangement for electronic-based consultations, including the costs involved.

The AMA said that in setting a fee for such consultations, practices needed to take into account indirect costs, including those involved in providing secure IT infrastructure and data lines, electronic billing arrangements and follow-up services.

In its second Position Statement, the Association warned that the benefits conferred by electronic communications between practitioners came with added risks that can, and should, be managed.

“Secure electronic communication is a priority tool to support doctors coordinating and managing quality care for their patients,” Professor Dobb said, but added the transmission of large volumes of data carried with it the danger that important pieces of information may be overlooked or neglected.

“There are inherent risks to doctors of an increased duty of care to patients if they receive large amounts of clinical information electronically, or if they are not aware that they have received certain information electronically,” he said.

To help doctors minimise and manage these risks, the AMA has advised doctors sending information to make sure a medical practitioner is identified in the salutation, that the purpose of the transmission is made clear, that only relevant information is attached, that the information is sent directly to a specific practitioner, that only other practitioners involved in the patient’s care are included, and that, where the matter is urgent, the transmission is followed by a telephone call.

Doctors receiving information electronically are advised to have a protocol for regularly checking incoming communications, ensure that relevant information is stored with the patient’s file, along with a record of any action taken, and that receipt of any urgent communication is confirmed with a phone call.

The Position Statement on technology-based patient consultations 2013  can be viewed at:

The Position Statement on medical practitioner responsibilities with electronic communication of clinical information 2013 can be viewed at:

Adrian Rollins

Published: 17 Dec 2013