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Medical Professionalism in Electronic Communication

Telemedicine, the provision of medical services through electronic media, has the potential to dramatically change how patient and physicians interact and how medical care can be delivered. [1] However, the use of electronic health information exchange poses significant challenges for physicians and patients alike. [2]

With the evolution and ease of electronic communication, the internet has become an important tool for patients seeking to expand their knowledge of health conditions and medications. [3] With the onset of online medical websites like WebMD, health information is readily available to patients. [4] Despite the pitfalls of self-diagnosis, online resources have the opportunity to provide patients with basic knowledge on a given topic, allowing for efficient clinical encounters to refine information and answer specific questions. [5]

With the advent of email, text messaging, and social media websites, electronic communication may represent an opportunity for health care providers to reduce costs and improve efficiency. [6] Health information technology can provide greater accessibility to physicians in real time. [7] Improved communication can lead to modifying treatment with more ease and ultimately better patient care. [8] Other advantages include greater access for patients, especially those in rural settings, reduced cost of medical care, a clear written record, and enhanced patient empowerment through self-education. [9] Electronic communication potentially enables physicians to remotely inform, comfort, encourage, and support families.

However, before electronic and internet-based patient-provider communication can become the standard of care, potential pitfalls must be addressed. Concerns range from privacy, malpractice liability, de-personalized care, time, and the ability to provide services without adequate remuneration. [10] The increased risk of compromised protected health information hazard a Health Insurance Portability and Accountability Act violation and subsequent damages. [11] Although encryption software may be used to protect health information, it has disadvantages in terms of viability, costs, usability, and compliance. [12] Electronic communication also decreases the rapport and patient satisfaction that comes with face-to-face verbal communication. [13] There is also the concern that electronic communication through email creates the expectation of immediate response, without any form of reimbursement. [14] Physicians would be forced into a 24/7-response arrangement without 24/7 access to individual medical records. [15] Other obstacles include unclear legal regulations and the delay in technology adoption. [16]

Electronic interaction in health care settings has the possibility to help make clinician-patient communication a more powerful health care tool, however, policies are needed to prevent the inappropriate use of telemedicine and to promote patient safety and quality care. [17] To establish safeguards, strategies must be institutionalized: establishing turnaround times for responses; informing patients of privacy issues; establishing what type of messages are appropriate over electronic communication; and what constitutes the need for an office visit. With health care costs on the rise, the potential for telemedicine is great, but the technology will continue to be underutilized without clear guidelines and safeguards. [18]



[1] What is Telemedicine? American Telemedicine Association,

[2] Online medical professionalism: Patient and public relationships. 158(8) Ann. Intern. Med. 620, 627 (2013).

[3] See Accept it, Wikipedia is a public health issue. Now let’s fix it. PharmExecBlog (Oct. 9, 2013),

[4] Id.

[5] Pamela Lewis Dolan, What’s missing from many health apps – medical expertise. American Medical News,

[6] Jeffrey P. Harrison, The role of e-heath in the changing health care environment. Medscape,

[7] Id.

[8] Id.

[9] Deal Olsen, Doctors, patients likely to talk more via email. The State Journal Register,

[10] Online medical professionalism, supra note 2.

[11] Sue Ter Maat, Health, fitness apps pose HIPAA risks for doctors. American Medical News,

[12] Id.

[13] Online medical professionalism, supra note 2.

[14] Olsen, supra note 9.

[15] Id.

[16] Neil Versel, Are HIPAA rules unclear on texting protected health information? MobiHealthNews (Sept. 12, 2012),

[17] Online medical professionalism, supra note 2.

[18] Id.