Neinstein L
Department of Medicine and Pediatrics, University of Southern California School of Medicine, Los Angeles, CA 90089-0311, USA.
J Adolesc Health. 2000 Jul;27(1):6-11. doi: 10.1016/s1054-139x(99)00119-6.
To examine the utilization and potential uses and problems of electronic communication with patients.
University and college health centers were surveyed about the type of utilization and policies of electronic communication with patients. The survey group consisted of 99 health centers predominantly serving students representing small-, medium-, and large-sized public and private colleges and universities. Eighty-nine health centers completed the survey.
Of the responding health centers, 63.6% use some form of electronic communication with patients. Twenty-seven percent of the health centers give out some form of medical advice via E-mail or the Internet; 14.7% give out some laboratory results via E-mail; 3.4% make appointments via E-mail; and 63.6% give out administrative advice by E-mail. While there was consistent concern expressed about confidentiality and security, only five health centers had a policy about electronic communication. Uses were most common in nonclinical areas but did include health education, Web sites, medical advice, laboratory results, appointment-making or confirmation, and contacting hard-to-reach patients including those studying abroad.
While electronic communication with patients was common, provision of direct medical advice was less common. Issues receiving little attention include determining the types of electronic communication that is acceptable to staff and students, determining the level of security of their current information system, educating staff about confidentiality and security issues, and establishing a comprehensive policy regarding electronic communication with patients.
探讨与患者进行电子通信的利用情况、潜在用途及问题。
对大学和学院健康中心就与患者进行电子通信的利用类型和政策进行调查。调查对象包括99个主要为学生服务的健康中心,这些健康中心代表了小型、中型和大型的公立及私立学院和大学。89个健康中心完成了调查。
在做出回应的健康中心中,63.6%使用某种形式与患者进行电子通信。27%的健康中心通过电子邮件或互联网提供某种形式的医疗建议;14.7%通过电子邮件提供某些实验室检查结果;3.4%通过电子邮件进行预约;63.6%通过电子邮件提供行政建议。虽然对保密性和安全性一直存在担忧,但只有五个健康中心有关于电子通信的政策。电子通信在非临床领域最为常见,但也包括健康教育、网站、医疗建议、实验室检查结果、预约或确认,以及联系难以接触到的患者,包括那些在国外学习的患者。
虽然与患者进行电子通信很常见,但直接提供医疗建议则不太常见。很少受到关注的问题包括确定工作人员和学生可接受的电子通信类型、确定其当前信息系统的安全级别、对工作人员进行保密性和安全性问题教育,以及制定关于与患者进行电子通信的全面政策。