Journal of General Internal Medicine

, Volume 28, Issue 7, pp 952–952 | Cite as

Capsule Commentary on Schickedanz et al.: Access, Interest, and Attitudes Toward Electronic Communication for Health Care Among Patients in the Medical Safety Net

Capsule Commentaries

Understanding and testing whether emerging technologies can improve provider–patient communications is important. The acceptability and use of these technologies/tools in vulnerable populations is particularly vital, as it could help reduce disparities in health and healthcare access. Schickendanz et al.1 examined the use of electronic communications in six San Francisco public health department clinics. They found that 55 % of safety net patients routinely used email and text messaging, and 87 % had a strong interest in using it for health matters. At the time of the study, only 17 % reported informal use of email with providers, and none of the clinics had secure communication portals. Patients believed it could improve clinic efficiency and communication with their providers, though they were concerned about creating additional work for busy clinicians and felt that some health issues could not be dealt with by email. Younger patients and those with higher income and education were more likely to want to use email, though even among those not using email, nearly half expressed an interest if secure email were available. Findings from this and other studies2 suggest that electronic communication is something that patients are willing to engage in with their providers in a variety of healthcare settings. Among vulnerable populations—including those receiving care in safety net setting—these findings are compelling, as e-communication represents a potential tool for improving patient-centered care.

The current evidence on the use of email for disease prevention and health promotion is weak, and inadequate to inform clinical practice.3 However, use of electronic interfaces such as email or telephone text messaging holds promise, as venues to improve patient–provider information sharing. Patients feel remarkably comfortable with providers sharing information with one another through health information exchanges.4 With the rise of technology and patients’ increasing comfort with and desire for email and texting, the promise of technology for increasing clinic efficiency and reducing clinician’s time demands may result in rapid adoption. This may stimulate rapid changes in clinical and medico-legal standards to deal with security and privacy challenges. Attitudinal barriers among both patients and providers, as well as structural and legal issues, are important areas for future research.


Conflict of Interest

The author declares that he/she does not have a conflict of interest.


  1. 1.
    Schickedanz A, Huang D, Lopez A, et al. Access, interest, and attitudes toward electronic communication for health care among patients in the medical safety net. J Gen Intern Med. 2013. doi:10.1007/s11606-012-2329-5.
  2. 2.
    Saidinejad M, Teach SJ, Chamberlain JM. Internet access and electronic communication among families in an urban pediatric emergency department. Pediatr Emerg Care. 2012;28(6):553–557.PubMedCrossRefGoogle Scholar
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    Sawmynaden P, Atherton H, Majeed A, Car J. Email for the provision of information on disease prevention and health promotion. Cochrane Database Syst Rev. 2012; Issue 11. Art. No.: CD007982. doi:10.1002/14651858.CD007982.pub2.
  4. 4.
    Ancker JS, Edwards AM, Miller MC, Kaushal R. Consumer perceptions of electronic health information exchange. Am J Prev Med. 2012;43(1):76–80.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  1. 1.Department of Family MedicineUniversity of Kansas Medical CenterKansas CityUSA

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