October 2014 - emailing health professionals

I wanted to divert away from the normal flow of my blog for a minute, so rather than be about me I have a couple of blogs that have been nagging away at me for a while regarding the beloved NHS. I say “beloved” because it is to me and to many people I know, we have come to expect it to be there for us when we need it and for all the issues that are being flagged up in the media right now, I still think this model is a shining light amongst healthcare systems around the world.

Clearly my views here are as a patient of the NHS, so I am not that familiar with the complexities and politics of the NHS, which is probably a good thing, because it helps see the issues more clearly. If you are a healthcare professional reading this, you may or may not agree with what I’m saying, and that is fine and often the way with a bit of healthy debate. I’m absolutely not an expert in healthcare, and I’m not suggesting that things aren’t being done all the time to improve patient experience and outcomes, because I know they are, I read about the good things all the time. But this is straying into the other nagging blog subject I’ve got in my head!

So my first subject is health professionals emailing patients, and vice versa. I’ve been involved in a few Twitter chats where this has come up, always views for and against the subject of emailing patients.

The consultant I have had the pleasure to deal with is Dr Partha Kar, Endocrinologist at Portsmouth’s Queen Alexandra Hospital. He is a big advocate of email as a useful patient support tool, in fact before my dealings with Dr Kar, I didn’t even realise it was an option. Let me tell you why I find it so beneficial.

A recent exchange was something like this – I had a regular Endocrine check-up coming up, so I had some blood tests to get done before my appointment with Dr Kar. I couldn't remember, and wanted to check, whether these blood tests were ‘fasting’ or not. So the two basic options were going to be:

Without email – I telephone the Endocrinology department, speak to the receptionist about my question, they take my details, details about the blood tests etc. and make a note to contact Dr Kar (exactly how this would happen I’m not sure, presumably either a computer system note, or pop in and see him in-between clinics, or after clinic)…..then once the relevant information has been obtained, telephone me back (if I'm not in, it may not be 'allowed' for them to leave a message on my answerphone). I envisage that depending on how busy all parties are, this may take a day or so, depending when I originally called, maybe the same day if I called early in the day.

With email – I email my question directly to Dr Kar. He answers within the hour, a simple “no” was all that was needed. A minute of his (valuable) time to read my email and reply.

I know which of the above is easier and quicker for me as a patient. I’ve had various exchanges of a similar nature, those queries which are really simple and quick to answer.

Now of course, not all patients are created equal and not all consultants are created equal. A patient may not have ready access to email, may not even want to use email. And of course the consultant may not want to give out their email address. 

I know there are several worries that health professionals have – “I don’t want to give out my email address because patients will contact me all the time”, “email isn’t secure, important patient details could get ‘hacked’ or lost”, “I haven’t got the time to start answering lots of emails”. So let me try and answer some of those…..

I don’t contact Dr Kar all the time; if I did I strongly suspect he would have put me straight by now. I know that his time is precious, so I’m not about to befriend him and drop him an email to say what a wonderful weekend I’ve had, or pass the time of day. I’m only going to use the email medium when I feel I have to, and when I am asking a question that is easily dealt with by email, mainly yes or no questions or quick updates on something we have spoken about at a face to face appointment. On the very rare occasion when I’ve misjudged that, Dr Kar replied to say make an appointment to come and see him.

OK, email isn’t totally secure or foolproof. Is there a single secure system available to health professionals that allows them to send and receive emails securely….from the Twitter chat I’ve seen there doesn’t appear to be ‘a single system’, although there does appear to be methods out there. The NHS is obviously strapped for cash, and developing such a system is going to take time and money, and certainly the latter may well be better spent elsewhere. But right now there are emails, easy to use and essentially free. I believe that more use could be made of email as a tool to make communications with doctors and patients easier, clearly it isn’t suitable for every medical occasion.

With regards to the “not enough hours in the day” argument. Doctors and patients have to converse somehow, and if you can spend a minute or two answering that simple yes or no email, isn’t that better than tying up other valuable resources in the process of answering those things. And whilst I’m saying the doctors answer the emails, it needn’t necessarily be (I know receptionists are horrendously busy too, but answering a few emails to cut down the number of phone calls.....might be a better balance?). I think there are healthcare professionals out there using email to their benefit and this best practice should be shared with others….if it can work for one it can work for others. Don’t just go down the “it won't work here” route because of course it won't if you don’t want it to. It must be possible to introduce this way of working in the short term whilst working on that longer term solution, if such a thing exists.

Also there will be a difference between the way email would work for hospital consultants and GP’s, but I have seen examples where some GP’s do offer communications by email, so again as above it can work in one practice it must be able to work in another. Sure you may not want to introduce blanket email for all patients about all subjects, but introduced sensibly and in a controlled way, what's the problem? I know that the doctors surgery I attend, and another surgery nearby work differently in quite a few ways, neither uses email to my knowledge. But why should there be such differences when they only about a mile apart?

The other example I saw today was the advertising of flu clinics using not only email, but also on the surgery website, Facebook and Twitter. So whilst I am advocating email here, other frequently used channels exist. How people communicate with the world is changing, if the surgery has a presence on Facebook, and the patient has ‘liked’ the page, then hey-presto a message appears in their feed that their doctors surgery is booking flu clinics. I don’t check my doctors surgery website every day, but I do read Facebook/Twitter every day. (well most days….) Yes, I know social media opens up another channel of communications you have to manage, but the same message from me, some obviously use it, why not others? Tell patients up-front what it can and can't be used for.

So I think that is all I wanted to get off my chest for the time being. The wider issue about all the things that the NHS has on its plate probably makes the debate of email seem all rather insignificant. But if you separate the seemingly massive insurmountable task that is ‘fixing’ the NHS it surely boils down to what little things can you do to improve the patient experience, what little things can be tried to help things just that little bit for patients. Things that may not even cost that much money to implement.

Why not try it, I can't guarantee it will 100% work for you first time, but I think your patients may thank you for it.