1. bookVolume 8 (2021): Issue 1 (January 2021)
    Health, Media and Participation
Journal Details
License
Format
Journal
First Published
01 Nov 2014
Publication timeframe
2 times per year
Languages
English
access type Open Access

Complexity and Simplicity in Doctor–Patient Email Consultations

Published Online: 03 Apr 2021
Page range: 1 - 18
Journal Details
License
Format
Journal
First Published
01 Nov 2014
Publication timeframe
2 times per year
Languages
English
Abstract

NEW TECHNOLOGIES HAVE FACILITATED DOCTOR–PATIENT EMAIL CONSULTATIONS (E-CONSULTATIONS). GUIDELINES FOR E-CONSULTATION USE IN DENMARK STATE THAT THEY SHOULD BE USED FOR SIMPLE, CONCRETE AND NON-URGENT QUERIES; HOWEVER, A SMALL-SCALE DANISH STUDY SUGGESTED THAT DOCTORS ENCOUNTER E-CONSULTATIONS THAT DO NOT MATCH THE GUIDELINES. THE PURPOSE OF THIS ARTICLE IS TO EXPLORE WHETHER E-CONSULTATIONS IN DENMARK REFLECT RECOMMENDATIONS THAT THEY SHOULD BE SIMPLE, SHORT, CONCRETE AND WELL DEFINED, AND IF NOT, WHAT FORMS OF COMPLEXITY ARE EVIDENT. WE INDUCTIVELY ANALYSED 1,671 E-CONSULTATIONS FROM 38 PATIENTS AGED 21–91 YEARS COMMUNICATING WITH 28 DOCTORS, 6 NURSES, 1 MEDICAL STUDENT AND 8 SECRETARIES. RESULTS SHOWED BOTH QUANTITATIVE COMPLEXITY IN TERMS OF NUMBER OF INTERACTION TURNS, COMMUNICATIVE PARTICIPANTS, AND QUESTIONS ASKED, AND QUALITATIVE COMPLEXITY RELATING TO PATIENTS’ PSYCHOSOCIAL CONTEXTS AND GPS’ BIOMEDICAL DISEASE PERSPECTIVE. THUS, DESPITE EXISTING GUIDELINES AND THE LEANNESS ASSOCIATED WITH THE EMAIL MEDIUM, MULTIPLE FORMS OF COMPLEXITY WERE EVIDENT. THIS MISMATCH HIGHLIGHTS THE NEED FOR THEORETICAL DEVELOPMENT AS WELL AS THE VALUE OF RE-EXAMINING EXISTING POLICIES AND GUIDELINES REGARDING EXPECTATIONS FOR E-CONSULTATION USE.

Keywords

Albersheim, S. (2010). E-mail communication in paediatrics: Ethical and clinical considerations. Paediatrics and Child Health, 15 (3), 163-168 Search in Google Scholar

Anand, S. G., Feldman, M. J., Geller, D. S., Bisbee, A., & Bauchner, H. (2005). A content analysis of e-mail communication between primary care providers and parents. Pediatrics, 115(5), 1283-1288. Search in Google Scholar

Andreassen, H. K. (2011). What does an e-mail address add? Doing health and technology at home. Social Science & Medicine, 72, 521-528. Search in Google Scholar

Andreassen, H. K., Trondsen, M., Kummervold, P. E., Gammon, D., & Hjortdahl, P. (2006). Patients who use e-mediated communication with their doctor: New constructions of trust in the patient-doctor relationship. Qualitative Health Research, 16(2), 238-248. Search in Google Scholar

Antoun, J. (2016). Electronic mail communication between physicians and patients: a review of challenges and opportunities. Family Practice, 33(2), 121-126. doi:10.1093/fampra/cmv101 Search in Google Scholar

Banks, J., Farr, M., Salisbury, C., Bernard, E., Northstone, K., Edwards, H., & Horwood, J. (2018). Use of an electronic consultation system in primary care: A qualitative interview study. The British Journal of General Practice, 68(666), e1-e8. doi:10.3399/bjgp17X693509 Search in Google Scholar

Beasley, J. W., Hankey, T. H., Erickson, R., Stange, K. C., Mundt, M., Elliott, M., . . . Bobula, J. (2004). How many problems do family physicians manage at each encounter? A WReN study. Annals of Family Medicine, 2(5), 405. doi:10.1370/afm.94 Search in Google Scholar

Blom, J. W., Hout, W. B. V. d., Elzen, W. P. J. D., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., . . . Gussekloo, J. (2018). Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis. Age and Ageing, 47, 705-714. Search in Google Scholar

Car, J., & Sheikh, A. (2004). Email consultations in health care: 2—acceptability and safe application. British Medical Journal, 329, 439-442. Search in Google Scholar

Carpentier, N. (2015) “Differentiating between access, interaction and participation”, Conjunctions vol. 2, issue 2. Search in Google Scholar

Carlson, J., & Zmud, R. (1999). Channel expansion theory and the experiential nature of media richness perceptions. Academy of Management Journal, 42(2), 153-170. doi:10.2307/257090 Search in Google Scholar

Cook, N., Maganti, M., Dobriyal, A., Sheinis, M., Wei, A. C., Ringash, J., & Krzyzanowska, M. K. (2016). E-mail communication practices and preferences among patients and providers in a large comprehensive cancer center. Journal of Oncology Practice, 12(7), 676-684. doi:10.1200/jop.2015.008722 Search in Google Scholar

Cornwall, A., Moore, S., & Plant, H. (2008). Embracing technology: Patients’, family members’ and nurse specialists’ experience of communicating using e-mail. European Journal of Oncology Nursing, 12(3), 198-208. doi:10.1016/j.ejon.2007.09.008 Search in Google Scholar

Daft, R. L., & Lengel, R. H. (1986). Organizational information requirements, media richness, and structural design. Management Science, 32, 554–571. doi: 10.1287/mnsc.32.5.554 Search in Google Scholar

Daft, R., Lengel, R., & Trevino, L. (1987). Message equivocality, media selection, and manager performance: Implications for information systems. MIS Quarterly, 11(3), 355. doi:10.2307/248682 Search in Google Scholar

Dash, J., Haller, D. M., Sommer, J., & Junod Perron, N. (2016). Use of email, cell phone and text message between patients and primary-care physicians: Cross-sectional study in a French-speaking part of Switzerland. BMC Health Services Research, 16(1). doi:10.1186/s12913-016-1776-9 Search in Google Scholar

Divo, M. J., Martinez, C. H., & Mannino, D. M. (2014). Ageing and the epidemiology of multimorbidity. The European respiratory journal, 44(4), 1055-1068. doi:10.1183/09031936.00059814 Search in Google Scholar

Fage-Butler, A. M., & Nisbeth Jensen, M. (2015). The relevance of existing health communication models in the email age: An integrative literature review. Communication & Medicine, 12(2/3), 117-128. doi:10.1558/cam.18399 Search in Google Scholar

Farr, M., Banks, J., Edwards, H. B., Northstone, K., Bernard, E., Salisbury, C., & Horwood, J. (2018). Implementing online consultations in primary care: A mixed-method evaluation extending normalisation process theory through service co-production. BMJ Open, 8(e019966). doi:10.1136/bmjopen-2017-019966 Search in Google Scholar

Greenhalgh, T., Wherton, J., Shaw, S., & Morrison, C. (2020). Video consultations for covid-19: An opportunity in a crisis? British Medical Journal 368(998). doi: 10.1136/bmj.m998 Search in Google Scholar

Grimsbø, G. H., Finset, A., & Ruland, C. M. (2011). Left hanging in the air: Experiences of living with cancer as expressed through e-mail communications with oncology nurses. Cancer Nursing, 34(2), 107-116. doi:10.1097/NCC.0b013e3181eff008 Search in Google Scholar

Grønning, A. (2006). Personen bag: Tilstedevær i e-mail som interaktionsform mellem kunde og medarbejder i dansk forsikringskontekst. [The person behind: Presence in email as interaction form between customer and employee in a Danish insurance context]. Frederiksberg: Samfundslitteratur. Search in Google Scholar

Hassol, A., Walker, J. M., Kidder, D., Rokita, K., Young, D., Pierdon, S., . . . Ortiz, E. (2004). Patient experiences and attitudes about access to a patient electronic health care record and linked web messaging. Journal of the American Medical Informatics Association, 11(6), 505-513. doi:10.1197/jamia.M1593 Search in Google Scholar

Hollander, J. E., and Carr, B. G. (2020). Virtually perfect? Telemedicine for COVID-19. New England Journal of Medicine 382(18), 1679-1681. doi:10.1056/NEJMp2003539 Search in Google Scholar

Hsiao, A. L., Bazzy-Asaad, A., Tolomeo, C., Edmonds, D., Belton, B., & Benin, A. L. (2011). Secure web messaging in a pediatric chronic care clinic: A slow takeoff of “Kids’ Airmail”. Pediatrics, 127(2), e406-e413. doi:10.1542/peds.2010-1086 Search in Google Scholar

Ishii, K., Lyons, M. M., & Carr, S. A. (2019). Revisiting media richness theory for today and future. Human Behavior and Emerging Technologies, 1(2), 124-131. doi:10.1002/hbe2.138 Search in Google Scholar

Joschko, J., Liddy, C., Moroz, I., Reiche, M., Crowe, L., Afkham, A., & Keely, E. (2017). Just a click away: exploring patients’ perspectives on receiving care through the Champlain BASETM eConsult service. Family Practice, 35(1), 93-98. doi:10.1093/fampra/cmx073 Search in Google Scholar

Kirsh, S. R., Ho, P. M., & Aron, D. C. (2014). Providing specialty consultant expertise to primary care: An expanding spectrum of modalities. Mayo Clinic Proceedings, 89(10), 1416-1426. doi:10.1016/j.mayocp.2014.04.016 Search in Google Scholar

Laerum, E., Steine, S., Finset, A., & Lundevall, S. (1998). Complex health problems in general practice: do we need an instrument for consultation improvement and patient involvement? Theoretical foundation, development and user evaluation of the Patient Perspective Survey (PPS). Family Practice, 15(2), 172-181. doi:10.1093/fampra/15.2.172 Search in Google Scholar

Liddy, C., Maranger, J., Afkham, A., & Keely, E. (2013). Ten steps to establishing an e-consultation service to improve access to specialist care. Telemedicine and e-Health, 19(12), 982-990. doi:10.1089/tmj.2013.0056 Search in Google Scholar

Luo, J., Logan, C., Long, t. P. and Bercovitch, L. (2009). Cyberdermatoethics I: Ethical, legal, technologic, and clinical aspects of patient–physician e-mail. Clinics in Dermatology, 27 (4), 359–366 Search in Google Scholar

Mirsky, J. B., Tieu, L., Lyles, C., & Sarkar, U. (2016). A mixed-methods study of patient-provider e-mail content in a safety-net setting. Journal of Health Communication, 21(1), 85-91. doi:10.1080/10810730.2015.1033118 Search in Google Scholar

Mold, F. E., Hendy, J., Lai, Y.-L., & de Lusignan, S. (2019). E-consultation in primary care: A systematic review. JMIR Medical Informatics, 7(4), e13042. doi:10.2196/13042 Search in Google Scholar

Plener, I., Hayward, A., & Saibil, F. (2014). E-mail communication in the management of gastroenterology patients: A review. Canadian Journal of Gastroenterology and Hepatology, 28(3), 161-165. doi:10.1155/2014/764538 Search in Google Scholar

PLO (2018). Overenskomst om almen praksis. [Collective agreement for General Practice]. Retrieved from https://www.laeger.dk/sites/default/files/overenskomst_om_almen_praksis_ok18_endelig_udgave.pdf Search in Google Scholar

PLO (2019). Honorartabel [Remuneration table]. Retrieved from https://www.laeger.dk/sites/default/files/honorartabel_2019_oktober-1.pdf Search in Google Scholar

PLO (2020). Aktivitet og økonomi i almen praksis i dagtid og vagttid 2009 til 2019 [Activity and economy in General Practice 2009-2019]. https://www.laeger.dk/sites/default/files/aktivitet_og_oekonomi_2019.pdf) Search in Google Scholar

Real, K., & Street, R. L. (2009). Doctor-patient communication from an organizational perspective. In D. E. Brashers & D. J. Goldsmith (Eds.), Communication to manage health and illness (pp. 65-90). Abingdon: Routledge. Search in Google Scholar

Reeve, J., Blakeman, T., Freeman, G. K., Green, L. A., James, P. A., Lucassen, P. L. B. J., . . . Weel, C. v. (2013). Generalist solutions to complex problems: Generating practice-based evidence - the example of managing multi-morbidity. BMC Family Practice, 14(112). doi:10.1186/1471-2296-14-11. Search in Google Scholar

Roter, D., Larson, S., Sands, D. Z., Ford, D. E., & Houston, T. (2008). Can e-mail messages between patients and physicians by patient-centered? Health Communication, 23(1), 80-86. doi:10.1080/10410230701807295. Search in Google Scholar

Skanderup Hansen, C., Lynghøj Christensen, K. & Ertmann, R. (2014). Patients and general practitioners have different approaches to e-mail consultations. Danish Medical Journal 61/6. Search in Google Scholar

Sowerbutts, H., & Fertleman, C. (2016). How best to use email with patients (Report). British Medical Journal, 352(8040), 81. Search in Google Scholar

Stoves, J., Connolly, J., Cheung, C. K., Grange, A., Rhodes, P., O’Donoghue, D., & Wright, J. (2010). Electronic consultation as an alternative to hospital referral for patients with chronic kidney disease: A novel application for networked electronic health records to improve the accessibility and efficiency of healthcare. Quality and Safety in Health Care, 10(e54). doi:10.1136/qshc.2009.038984. Search in Google Scholar

Varsi, C., Gammon, D., Wibe, T., & Ruland, C. M. (2013). Patients’ reported reasons for non-use of an internet-based patient–provider communication service: qualitative interview study. 15(11). doi:10.2196/jmir.2683. Search in Google Scholar

Voruganti, T., Husain, A., Grunfeld, E., & Webster, F. (2018). Disruption or innovation? A qualitative descriptive study on the use of electronic patient-physician communication in patients with advanced cancer. Supportive Care in Cancer, 26(8), 2785-2792. doi:10.1007/s00520-018-4103-7. Search in Google Scholar

Ye, J., Rust, G., Fry-Johnson, Y., & Strothers, H. (2010). E-mail in patient-provider communication: A systematic review. Patient Education and Counseling, 80(2), 266-273. doi:10.1016/j.pec.2009.09.038. Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo