Few Doctors Use IT, Survey Says

Has your doctor been ignoring your e-mails?

Don’t worry, she probably just never checks her account. According to a survey led by researchers from Massachusetts General Hospital, less than half of 1,662 doctors across the country say they incorporate common information technology (IT), such as e-mail, into their clinical practices. The survey, conducted in 2004 and set to be published next month, revealed that although the use of IT has become prevalent in most other professions, only 30 percent of physicians maintain regular e-mail contact with colleagues and less than 4 percent communicate consistently with patients via e-mail.

“The use of information technology among doctors was much lower than what we had expected, especially since e-mail is such an efficient way of communicating,” said Richard W. Grant, an assistant professor of medicine at Harvard Medical School and the lead author of the study. “There’s no time lag and no phone tag.”

The researchers found that doctors who practiced within academic centers and Health Maintenance Organizations were more frequent IT users than their colleagues in smaller practices.

Eric G. Campbell, an assistant professor at the Institute for Health Policy and a co-author of the study, did not find the results to be indicative of a problem in the medical profession.

“I personally hate e-mail,” Campbell said. “In today’s electronic culture, we assume that if a technology is widely used, it is better. But in the medical profession, e-mail can be both impersonal and problematic.”

Few health insurance companies compensate doctors for the time they spend writing e-mails to patients, and few e-mail servers can guarantee complete security, both possible reasons why physicians are reluctant to communicate electronically with patients, Campbell said.

David M. Cutler, dean for the Social Sciences in the Faculty of Arts and Sciences and the author of “Your Money or Your Life: Strong Medicine for America’s Health Care System,” said that physicians are reluctant to use e-mail because it isn’t profitable. “Doctors don’t use e-mail because they don’t make money from it. Care for patients in non-emergency situations is poor, and until people get sick of a system that’s not user-friendly, policies won’t change.”

According to Catherine M. DesRoches, a senior research associate at the Harvard School of Public Health, the infrequent use of e-mail indicated by the survey does not necessarily imply that physicians are not using IT to communicate. DesRoches said many technologies that doctors incorporate into clinical practice, such as online prescriptions and electronic reminders for disease screening, were not included in the survey. The results and analysis of the survey will appear in the November issue of the Journal of General Internal Medicine.