Kittler A F, Wald J S, Volk L A, Pizziferri L, Jagannath Y, Harris C, Lippincott M, Yu T, Hobbs J, Bates D W
Partners HealthCare Information Systems, Department of Clinical Analysis, Wellesley, MA, USA.
Int J Med Inform. 2004 May;73(4):333-40. doi: 10.1016/j.ijmedinf.2004.02.004.
Few studies have explicitly addressed how e-mail technology may affect non-physician clinic staff, even though these staff typically manage tasks well suited to e-mail communication such as requests for prescription renewals, laboratory and test results, and referral authorizations.
We conducted a survey of staff members at 10 primary care clinics in Boston to further evaluate non-physician staff attitudes towards e-mail use with patients. We subsequently re-surveyed staff at three of these clinics after the implementation of Patient Gateway, an application designed to facilitate secure electronic communication between patients and the clinics.
Before Patient Gateway implementation, 88% of surveyed staff were already using e-mail at least once a day for work-related communication. Many of these staff members (24%) were already using e-mail with patients. Forty-eight percent of staff members thought that increasing e-mail use with patients could improve the quality of care their practices delivered. However, staff reported having some hesitations about increasing e-mail use with patients, mostly relating to security, confidentiality, and workload. After Patient Gateway implementation, users reported high satisfaction with the application and staff in general (users and non-users of Patient Gateway) felt more enthusiastic about increasing e-mail use with patients.
In order to maximize the potential of staff-patient e-mail, it is important that concerns relating to security, confidentiality, and workflow are addressed, and patients must be given guidelines for the appropriate use of e-mail. Secure applications designed with these issues in mind are likely to be well received by staff members, and in turn physicians.
尽管非医师门诊工作人员通常负责处理一些非常适合通过电子邮件沟通的任务，如处方续签请求、实验室和检查结果以及转诊授权，但很少有研究明确探讨电子邮件技术可能如何影响这些人员。
我们对波士顿10家初级保健诊所的工作人员进行了一项调查，以进一步评估非医师工作人员对与患者使用电子邮件的态度。随后，在实施了旨在促进患者与诊所之间安全电子通信的应用程序“患者网关”之后，我们对其中三家诊所的工作人员进行了重新调查。
在实施“患者网关”之前，88%的受访工作人员已经每天至少使用一次电子邮件进行工作相关的沟通。其中许多工作人员（24%）已经在与患者使用电子邮件。48%的工作人员认为增加与患者使用电子邮件可以提高他们所提供医疗服务的质量。然而，工作人员报告说在增加与患者使用电子邮件方面存在一些犹豫，主要涉及安全、保密和工作量。在实施“患者网关”之后，用户对该应用程序表示高度满意，而且总体上工作人员（“患者网关”的用户和非用户）对增加与患者使用电子邮件更有热情。
为了最大限度地发挥工作人员与患者之间电子邮件的潜力，解决与安全、保密和工作流程相关的问题很重要，并且必须为患者提供电子邮件适当使用的指导方针。考虑到这些问题而设计的安全应用程序可能会受到工作人员的欢迎，进而也会受到医生的欢迎。
