E-mail communication in pain practice: The importance of being earnest

BACKGROUND: Information technology can play a vital role in meeting patient needs and reinforcing the relationship among patients and their pain physicians. However, strong resistance remains on the medical side to this type of non-frontal care. OBJECTIVES: The primary objective of this study was to assess the effectiveness of an E-mail intervention on customers’ satisfaction. The secondary goals were to analyze the messages from patients to their clinician (not only the volume but also the content) and the impact on client, professional and health services outcomes. STUDY DESIGN: A prospective, non-randomized evaluation of patients undergoing treatment for chronic pain from September 2011 to May 2012. SETTING: A private, specialty referral center in Spain. MATERIALS AND METHODS: Participants were users visiting the Pain Management Unit evaluated by one physician. The E-mail address of the facility was written in every medical report provided. Patient satisfaction at the end of the 8-month trial period was assessed and outcomes recorded. RESULTS: Patients reported better communication with their therapist and greater satisfaction with overall care. 780 E-mails were read. Specialists received an average of 5 messages per day (standard deviation 0,3). None of them was unsuitable. LIMITATIONS: This is a prospective, single center evaluation performed by one doctor. There was no control group due to ethical considerations. CONCLUSIONS: Electronic communication is a cheap, easy and feasible way to address a wide range of concerns, thus enhancing patients’ satisfaction. More efforts are needed to implement routinely usage of this tool. If used appropriately, E-mail can facilitate physician-dependent interactions, promote access to care, save time and reduce costs. Concerns about billing, improper utilization, privacy and confidentiality might complicate its introduction and acceptance. Internet access remains a significant barrier to online patient-provider transference.