Primary care physician attitudes towards using a secure web-based portal designed to facilitate electronic communication with patients

Anne Kittler, Lisa Pizziferri, Lynn Volk, Yamini Jagannath, Jonathan Wald, David Bates


Background Patient demand for email contact with physician practices is high. If physicians met this demand, improvements in communication, quality of care and patient satisfaction could result. However, physicians have typically been hesitant to communicate electronically with patients, largely due to concerns relating to workload, security and lack of compensation.
Goal To assess physician attitudes towards electronic communication with patients six months after the implementation of an application called Patient Gateway. Patient Gateway allows patients to access an extract of their medical record and facilitates online communication with medical practices.
Methods A paper-based survey was administered to the 43 primary care physicians in one integrated delivery system, with a 56% (24/43) response rate.
Results Overall, physicians felt that Patient Gateway’s impact on their practices was positive, especially in the areas of refill and referral request management and appointment scheduling. However, physicians are still hesitant to increase general electronic communication with patients; none opted to use Patient Gateway’s general messaging function with patients, and those who had previously used outside systems to exchange emails with some patients continued to communicate with only a small proportion of their patient panel in this way. However, 38% of physicians already communicate with their own physicians via email, and another 19% would like to do so.
Conclusions Physicians’ fears about being overwhelmed with messages were not realised. While physicians were generally enthusiastic about the application, none used it directly to communicate with patients. Over three-quarters of respondents indicated that they would be more enthusiastic about electronic communication with patients if this time were compensated.


direct electronic messaging; electronic health record system; physician–patient electronic communication

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