Email communications between patients, physicians improve overall health

A third of patients with chronic conditions who exchanged secure emails with their doctors said that these communications improved their overall health, according to a Kaiser Permanente study published today in the American Journal of Managed Care.

"We found that a large proportion of patients used email as their first method of contacting health care providers across a variety of health-related concerns," said Mary E. Reed, DrPH, staff scientist with the Kaiser Permanente Division of Research in Oakland, Calif. and the study's lead author. "As more patients gain access to online portal tools associated with electronic health records, emails between patients and providers may shift the way that health care is delivered and also impact efficiency, quality and health outcomes."

The study is among the first to examine how the ability to send secure emails to doctors affects patient behavior, preferences and perceptions about their own health care.

Researchers surveyed 1,041 Kaiser Permanente patients in Northern California who had chronic conditions such as asthma, coronary artery disease, congestive heart failure, diabetes or hypertension. Survey participants included patients who had used Kaiser Permanente's online patient portal, My Health Manager, to send secure email messages, as well as patients who had not sent any messages. Surveys were completed in 2011 by mail, online or by telephone interview to ensure that access to technology would not affect response rates.

My Health Manager is an important part of Kaiser Permanente's efforts to engage patients in their health care by providing them timely, online access to their health records. Members can utilize the portal to schedule online appointments, refill prescriptions and send secure email messages to their health care providers. Patient-initiated emails are usually answered within 24 hours. In 2014, Kaiser Permanente members sent more than 20 million secure emails to providers through the portal.

Among the survey's key findings:

• Virtually all patients with chronic conditions said that exchanging email with their health care provider either improved (32 percent) or did not change their overall health (67 percent); less than 1 percent said that emailing made their health worse.
• More than half of respondents (56 percent) had sent their provider an email within the previous year, and 46 percent used email as the first method of contact for one or more medical concerns.
• Among patients who had emailed their health care provider, 42 percent reported that it reduced phone contacts and 36 percent said it reduced in-person visits.

Among email users, 85 percent of patients with higher cost sharing reported choosing email as their first method of contact, compared with 63 percent of patients with lower cost sharing. Patients were defined as having overall higher cost sharing if they reported a deductible or copays of $60 or more for office visits.