Thank you for your response concerning the crucial issue of security when using e-mail for the transfer of clinical information. Rather than dismissing the issue of security I recognise that this is something that needs to be explored. Your point raises questions about what people view as ‘confidential’ information and this view will differ, regardless of the view of the sender. This is especially likely to be the case in a healthcare setting.
While contact between banks and insurance companies and their customers is largely routine, there are occasions where e-mail exchanges do contain information that an individual is likely to consider personal; for instance details about insurance claims or insurance policies attached to e-mails. Therefore use of e-mail by these sectors even when restricted to ‘defined conditions and for strictly limited purposes’ does not necessarily exclude confidential information.
If we then think about the healthcare setting, an individual GP has responsibility for the information they send in an e-mail, but must also respect patient autonomy with regard to their views on what is appropriate content for an e-mail. Where e-mail consultations are initiated by the patient, the patient freely makes the decision to send clinical information via e-mail. The notion of confidentiality in this scenario becomes more complex; is it as defined by the GP, or does the patient’s decision override any professional judgement?
Given that GPs are already using e-mail with their patients we should be focused on finding a solution to the issue of security and confidentiality that will work in a healthcare setting, drawing on experiences with existing methods of communication and reflecting on how other sectors have managed such contact. We need formal guidance that facilitates and protects rather than restricts GPs and patients.
- © British Journal of General Practice 2013
