Patient Email Collection: A case study on collecting patient emails from a Family Health Team perspective

Secure email is one of the most common forms of communication today. In order to communicate effectively with patients, clinics may have to use patient emails. There is a mounting evidence to suggest that patients prefer this form of communication as a new standard for care as it allows for greater participation in their own healthcare journey._¹ In a recent survey by Canada Health Infoway, 45% of respondents expressed that they would like the ability to consult with a health care provider via e-mail.² Currently in Ontario, there are several technologies supporting primary care clinicians including electronic referral online appointment booking, virtual visits, and eForms where patient email enables better value for patients with enhanced opportunities to access and engage in care.

However, many organizations have been reluctant to incorporate email correspondence in their practice due to potential risks associated with patient privacy, adherence to PHIPA regulations/Canadian Anti-spam Legislation and other ethical concerns. As a result, many organizations may avoid using digital health tools altogether.³ These concerns highlight the importance of implementing sustainable e-consent systems that ensure patients are informed, consent is captured, and patient privacy is protected. In doing so, the risks associated with email communication can be mitigated, and the adoption of electronic communication can be championed.⁴

In 2017, Two Rivers Family Health Team implemented a number of strategies to collect patient emails and consent, which to this date continues. Most patients in the clinic agreed to have their emails collected without much apprehension, but some patients have declined mostly out of concern for security and privacy-related issues.

Patients have realized the many benefits of having their emails on file:

Implementation of patient email collection at the clinic was overall met with minor resistance from the staff. There were some concerns regarding the impact patient email collection would have on the job security of some of the staff members. The staff were assured that patient email collection would improve their workflow by allowing more time to be spent on providing more patient-centered care.

Two Rivers Family Health Team experienced the following benefits

Email allowed their patients to:

• Receive appointment reminders received via email regarding an upcoming appointment
• Stay updated regarding the status of their referral appointments through the eReferral platform, as well as receive notifications on time and location of appointments once available
• Receive helpful patient education materials and pamphlets in a timely manner
• Receive forms in advance and fill them out prior to appointment, ensuring the appointment time is used to interact with the clinician

Email allowed their clinic staff to:

• Concentrate on patient-centred care by reducing the number of minutes spent on phone communication – some of the inconveniences that result from phone communication, such as missed phone calls, were also reduced
• More time in schedules to focus on higher priority items, due to the reduction of manual labour tasks (i.e., preparing envelopes to be mailed out)
• Easily and quickly share documents, rather than having to physically mail them out
• Send out necessary communication to patients outside of regular office hours, giving clinicians more flexibility in their schedules

Benefits for the clinic overall:

• Avoided printing and stamp costs, as well as costs for clinic staff hours spent on preparing envelopes for mail-outs
• Reduction in no-shows by having reminders emailed out to patients prior to appointments
• Patients more likely to cancel appointments in advance with reminders, giving the clinic ability to re-book timeslots ensuring continuity of revenues

1. Virji, A., Yarnall, K. S. H., Krause, K. M., Pollak, K. I., Scannell, M. A., Gradison, M., & Østbye, T. (2006, August 15). Use of email in a family practice setting: Opportunities and challenges in patient- and physician-initiated communication – BMC medicine. BioMed Central. Retrieved April 8, 2022, from https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-4-18
2. Canada Health Infoway. (2021, November). Canadian Digital Health Survey 2021: What Canadians Think. https://www.infoway-inforoute.ca/en/component/edocman/4011-canadian-digital-health-survey-2021-what-canadians-think/view-document?Itemid=0
3. Sowerbutts, H., & Fertleman, C. (2016, January 12). How best to use email with patients. The BMJ. Retrieved April 11, 2022, from https://www.bmj.com/content/352/bmj.h6225
4. Communicating personal health information by email. (n.d.). Retrieved April 11, 2022, from https://www.ipc.on.ca/wp-content/uploads/2016/09/Health-Fact-Sheet-Communicating-PHI-by-Email-FINAL.pdf
5. eHealth Centre of Excellence (2022, April). eReferral Patient Experience Survey 2022
6. 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. https://doi.org/10.1016/j.pec.2009.09.038