Table 4

Guidelines for email exchange between doctor and patient

Adapted from the American Medical Informatics Association.40
Joint responsibilities
    • Establish what the purpose(s) of email exchanges will be
    • Establish the turnaround time expected of both doctor and patient (possibly depending on context)
    • Avoid anger, sarcasm, criticism, and libellous references to third parties
    • Use encryption to protect the privacy of email content
The doctor's responsibilities
    • Ensure the patient is aware of security and confidentiality issues
    • Obtain the patient's informed consent for the use of email, specifying your terms
    • Protect access to your email inbox and your screensaver with passwords
    • Do not distribute a patient's email to third parties, unless they have agreed to it
    • Use an electronic signature and a header to warn about privacy issues
    • Set up an automatic reply to confirm receipt of patient's email
    • File printouts of all email correspondence in the medical record
    • Back up your email folders weekly
    • Maintain an address book of patients who can be (anonymously) mass mailed in the event of technical problems
The patient's responsibilities
    • Categorise the email in its subject heading
    • Use identifying information (such as a hospital number) in the body of the email
    • Use an electronic signature
    • Acknowledge receipt of doctor's reply