What does the available clinical research on the use of electronic communication between patients and physicians show?
Most studies have been done in primary care populations, commonly in large, multisite integrated-provider networks. Patients are generally very satisfied with e-mail and Web-based messaging, and often prefer it to the telephone for routine matters such as scheduling appointments or requesting prescription refills. Physicians find it a useful modality for the management of chronic diseases in patients they know well.2 Contrary to their initial biases, most physicians are not overwhelmed with messages from patients, and most patients are able to follow specific guidelines regarding its use. However, the data are mixed as to whether it truly saves time for the physician or decreases the volume of phone calls coming into an office. Currently, physician reimbursement for its use is meager to nonexistent, though some third-party payers are implementing programs to pay physicians for care rendered online. What guidelines should be followed by practices wishing to initiate electronic communica
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