University of Michigan study finds patients and physicians encourage e-mail use

October 11, 1999

NEW YORK - Although 40 percent of general medicine clinic patients regularly use e-mail, only 14 percent of them have used it to communicate with their doctors, a recent survey by researchers at the University of Michigan Health System has found.

But patients say they want e-mail access to their doctors: 70 percent of patients (both e-mail users and non-users) surveyed said they would like to communicate with their health care provider via e-mail.

At the same time, 83 percent of the patients' physicians said they thought e-mail was a good way to answer patients' non-urgent medical questions, even though only 27 percent said they were currently using e-mail to communicate with patients. These results suggest that there is great opportunity to facilitate electronic communication between patients and their doctors.

The survey of 320 patients and 75 resident physicians was conducted at the outset of a larger study at the University of Michigan and the Ann Arbor Veterans Affairs Hospital, which will now evaluate a specially designed e-mail system that facilitates electronic communication between patients and physicians.

The system, known as EMAIL (Electronic Messaging, Advice, and Information Link), allows patients to communicate with their doctors through an electronic triage system about such things as appointment times, referrals, prescription renewals, or general health questions. The preliminary survey was conducted to determine baseline e-mail use patterns and attitudes toward the use of e-mail.

The EMAIL study, directed by David Stern, MD, and Steven Katz, MD, MPH from the U-M Department of Internal Medicine and the Ann Arbor VA Hospital, was introduced in the U-M General Medicine Clinic in August 1999. All resident physicians with on-site clinics are participating and have been randomized into a "study group" and a "control group." Patients of the physicians in the study group receive detailed information about the new system and are encouraged to use it.

The goals of the study are to identify:
  1. which subjects patients and physicians use e-mail to communicate about most often
  2. how e-mail use may affect the volume of telephone calls, visits, and overall efficiency of the organization
  3. how e-mail use influences the satisfaction of patients and physicians, especially with regard to the patient/physician relationship
  4. the efficiency and timing of communication among patients, triage nurses, and physicians

The study is funded by the Intel Corporation and represents a collaborative effort of researchers at CHOICES (the Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies) and MICHI (the Michigan Collaboratory for Health Informatics) at the U-M. CHOICES is a research unit funded jointly by the Departments of Internal Medicine and Surgery devoted to the multidisciplinary study of the quality and economic impact of health care services.

Results of the baseline survey from the EMAIL study are being presented at Intel's Internet Health Day II in New York.
Internet Health Day II was developed by Intel Corporation as a forum for leaders in the emerging Internet Health industry. Internet Health Day 1998 identified how consumers are being empowered by the Internet to find new ways of obtaining health-related information, products and services. Internet Health Day II explores solutions for bringing health care providers into the online world.

Internet Health Day II is sponsored by the American Academy of Pediatrics, American Medical Association, American Medical Informatics Association, American Pharmaceutical Association, Internet Healthcare Coalition and People's Medical Society. For more information, please visit

For more information on the EMAIL study, contact the Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (CHOICES) at the University of Michigan at 734-647-8094, e-mail, or visit the CHOICES website at

University of Michigan Health System

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