When it comes to using electronic communication with patients, what is appropriate? What is the value of face-to-face versus electronic communication?

Posted in Risk Management on Wednesday, July 31, 2019

It is no surprise to learn that the millennial generation prefers electronic communication, such as texting or emailing patients and peers. For physicians and all healthcare providers, electronic communication can appear to be a boon in time saving. However, there are certain considerations beyond HIPAA to be aware of when it comes to communicating electronically with your patients.

Below we explore the value of face-to-face vs. electronic communication.

Face-to-Face Communication

• One of the many potential issues you may face communicating via electronic methods, particularly in the healthcare setting, is losing the ability to “experience” the patient personally. You are able to see, hear and perceive the patient’s communication when you are together in the room.
• You may tend to be more careful, or at least aware, of the volume and nature of the information disclosed. In a nutshell, you are conscious of the setting and your audience.

Electronic Communication

• You are not able to hear the tone or voice inflections in the patient’s communication. In fact, you interpret the tone, inflection and mood in your mind when you are simply reading someone’s text or email.
• You cannot see the body language and nonverbal communication of the patient.
• You may not be as careful in your electronic communication due to a lack of awareness about who will view what you say compared to how careful you would be in person.

So with these facts, the question arises: Are you comfortable communicating with patients digitally (email, text) about conditions or treatment? Are you getting the entire picture?

Technology is amazing, but it still takes a backseat to face-to-face communication. Being able to present material clearly in person (avoiding a “lost in translation” scenario), reacting to patients in your practice personally and being available for discussion are the main reasons why face-to-face is critical.

When you consider face-to-face communication:

• Only about 10% of the conversation is the verbal aspect: the wording itself.
• About 30% consists of tone—how the patient is using pauses, speed, emphasis or volume to get their point across.
• The rest, about 60%, is body language. Facial expression, gaze (or lack of eye contact), gestures, posture and distance all factor heavily on the words used by the patient.

When you consider electronic communication:

• Keep in mind all devices that are used to communicate with patients become discoverable during malpractice litigation. Devices run the risk of being confiscated and sorted through very thoroughly—in these cases, all the information on the device is looked at in order to decipher whether any of it pertains to the case at hand.
• There is always a patient privacy component, including HIPAA concerns. While your device might be encrypted, there is no guarantee that the patient is using encrypted software.
• All patient communications, including digital communications, need to be captured and made part of the patient’s file.

While it may be preferred, and even easier, to send electronic communication to your patients, from a risk management standpoint sticking with face-to-face conversations will bring the most value to your practice and the patient experience.