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Doctors & Hospitals
by Tina Adler, AARP Bulletin, July 12, 2010
To keep your health or improve it, you may want to consider becoming a pen pal with your doctor—by e-mail. In a new Kaiser Permanente study, patients with diabetes, hypertension or both saw improvements in blood sugar, blood pressure and other measures after they began using secure e-mail as one way to communicate with their doctors.
The study, which was published in the July 7 issue of Health Affairs, observed 35,423 patients in the Kaiser Permanente system. To track the effects of doctor-patient e-mails, the researchers checked Kaiser’s extensive electronic health records every two months during the three-year study to see how often the patients went for recommended screenings and what their medical test results showed.
The researchers focused on hypertension and diabetes because both are common—and expensive—conditions to manage, said coauthor Terhilda Garrido, vice president of health information technology transformation and analytics at Kaiser Permanente.
They studied people who chose to use e-mail on their own, looking at their test results before and after they began e-mailing and then comparing their test results with those of a control group who didn’t use e-mail.
Patients e-mailed their doctors to discuss a change in their health, lab results, a new symptom, drug doses or a new drug they were taking, the team reported.
Physicians participating in the study reported that the e-mails helped patients follow medical instructions to the letter.
Whether e-mail is useful to patients—and not just a time-saver for doctors—is a critical question because of the new push to save on health care bills through increased use of information technology, the researchers note. The study is one of the first to show that electronic communication has a measurable, positive effect on patient health, in addition to saving money and improving efficiency.
For patients with diabetes, the team looked at their screening tests for HbA1c, an indicator of blood sugar control; LDL or “bad” cholesterol; and retina and kidney disease. For patients with hypertension alone, the team monitored blood pressure results.
Diabetes patients who e-mailed did between 2 to 6.5 percent better on tests compared with diabetes patients who did not e-mail. And, they tended to keep scheduled monitoring appointments better.
“The study adds to the body of knowledge that illustrates the potential value of using secure e-mail for selected patients,” says Hardeep Singh, M.D., with the Houston VA Health Services Research and Development Center of Excellence. However, “we still need evidence for other types of conditions, such as heart failure patients,” he adds.
He also warns that patients must never rely on e-mail in an emergency.
Kaiser Permanente’s secure e-mail tool, called “E-mail my doctor,” is one of the most popular features of the My Health Manager comprehensive personal health record, according to the company.
In fact, for some patients, e-mailing their doctor was a pleasant, personal experience. One woman said it reminded her of the days of Marcus Welby, “when doctors used to make house calls,” Garrido says.
Tina Adler is a freelance writer who covers health, science and the environment.
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