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Workflow, implementation and attitudes among family physicians using electronic communication with patients: results from a cross-sectional survey
ABSTRACT
Background:
The use of electronic communication between physicians and patients remains limited in some regions due to workflow challenges and lack of practical guidance on implementation.
Objective:
This study investigates reasons for, workloads, workflows and satisfaction related to electronic communication between physicians and patients in Ontario, Canada to inform broader electronic communication adoption in primary care.
Methods:
From June to August 2017, family physicians from the Department of Family and Community Medicine at the University of Toronto in Ontario, Canada were asked to fill-out an electronically disseminated 47-item questionnaire that surveyed their practices regarding electronic communication use with patients. Descriptive statistics, chi-squared tests and t-tests (P <.05) were used to describe physician reasons for using electronic communication, electronic communication workload and workflows, and factors associated with recommending electronic communication use to colleagues.
Results:
Of the 865 responses received from the 1553 surveys distributed, 610 respondents met inclusion criteria and 391 were analyzed due to personally using electronic communication or their staff using electronic communication with patients in an average week. Answering clinical questions, providing test results, sharing educational resources, and following up on symptom progression were the most common reasons physicians used electronic communication with patients. The majority of physicians communicated electronically with patients outside of office hours and did not have incoming electronic communications reviewed by another team member prior to looking at them. Physicians were more likely to recommend electronic communication use to a colleague if they used electronic communication for clinical communications, used electronic communication more often, reviewed electronic communications during regular clinic hours, had electronic communications reviewed by a staff member prior to physician review and a secure electronic communication portal was used.
Conclusions:
Using electronic communication to address clinical issues, dedicating in-clinic time for physician electronic communication review, leveraging secure e-messaging portals and implementing a triage system for electronic communication review increases physician satisfaction with regards to communicating electronically with patients. These practices could be leveraged along with financial incentives and improved technical integration of electronic communication into electronic medical records (EMRs) to increase the use of electronic communication between physicians and patients. Clinical Trial: N/A
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