5 ways inbound email is transforming healthcare

Stephen Ginn notes in his article published in BJPsych Advances, "In 2021 the total number of business and consumer emails sent and received each day worldwide was forecast as more than 319 billion and predicted to grow to over 376 billion by the end of 2025." While email may seem like a basic technology, its use is changing how healthcare providers communicate with patients, manage workflows, and deliver care.

However, this use comes with some disadvantages. According to Paubox's "2025 Healthcare Email Security Report," 60% of healthcare organizations experienced email-related security incidents last year, and 73% expect breaches to continue in 2025. As Rick Kuwahara, Chief Compliance Officer at Paubox, observes: "These breaches reveal a pattern of preventable failure. Like most industries, Healthcare relies on email, but most organizations are using tools that were never designed for today's cyberthreats." The contrast between email's transformative potential versus its security vulnerabilities is the main reason why strategic implementation is important.

While "the healthcare sector was initially more cautious about the adoption of email than other sectors," Ginn observes that "email is now a primary method of correspondence between healthcare professionals." A Cochrane systematic review titled "Email for clinical communication between healthcare professionals" found that by the mid-2000s, approximately two-thirds of surveyed US physicians were utilizing email to communicate with fellow healthcare professionals. 

The Paubox report reveals that 83% of healthcare IT leaders say legacy email systems disrupt day-to-day operations, while 74% report dissatisfaction with their current email security solutions. Matt Murren, CEO of True North ITG, states "The bottom line is legacy email platforms cost more than they save. They erode productivity, increase exposure to cyber threats, and ultimately compromise the quality of patient care."

Read also: The difference between inbound and outbound email

1. Streamlining patient intake and registration

Inbound email systems now allow healthcare facilities to send digital intake forms directly to patients before their appointments. Patients can complete their medical history, insurance information, and consent forms from their homes, reducing administrative burden and improving data accuracy.

Research supports the effectiveness of this approach. A study published in the Journal of the American Medical Informatics Association in 2004, "A Content Analysis of E-mail Communication between Patients and Their Providers: Patients Get the Message," found that 82.8% of patient emails addressed a single issue, demonstrating that patients can provide focused, organized information when given clear guidelines. This approach is valuable for specialist clinics and surgical centers, where pre-visit information is needed. By collecting this data via secure email channels, healthcare providers can review patient information in advance, leading to more productive appointments and reduced wait times.

2. Enhancing patient-provider communication

Patients can send questions about medications, report symptoms, request prescription refills, or clarify post-visit instructions without telephonic consultations or scheduling appointments.

The 2004 study revealed that information updates to physicians were the most common message type, accounting for 41.4% of all patient emails, followed by prescription renewal requests at 24.2% and health questions at 13.2%. Notably, the research found that only 5.1% of messages included sensitive content, and zero percent were urgent messages.

Many healthcare systems now route these inbound emails to appropriate care team members or integrate them with patient portals, ensuring timely responses while maintaining HIPAA compliance. According to the Paubox report, 93% of healthcare IT leaders say HIPAA compliance matters specifically when it comes to email yet the reality often falls short of expectations. This communication model respects both patient and provider schedules, making healthcare more accessible for working parents, elderly patients, and those managing chronic conditions who need regular communication with their care teams.

However, Ginn warns, "many clinicians may be emailing their patients without referring to guidance... with possible patient safety and medicolegal consequences." He advises that "email may best be viewed as a complementary method of communication with patients and suitable for use in some circumstances, but its use should be avoided for urgent, complex or sensitive messages."

3. Automating appointment management

Patients can reply to appointment reminders to confirm, cancel, or request changes. Advanced systems use natural language processing to understand patient intent and automatically update scheduling systems or route requests to appropriate scheduling staff.

The 2004 study found that appointment-related requests comprised 5.4% of patient emails, while prescription renewals accounted for nearly a quarter of all messages. The research also revealed that less than half (43.2%) of patient emails required an actual physician response, demonstrating how staff-based triage systems can efficiently manage communications and free up physician time.

This automation reduces no-show rates, some facilities report reductions of up to 30%, while freeing up staff time previously spent on phone calls. The email trail also creates a documented record of appointment communications, which is useful when it comes to operational analysis and dispute resolution.

4. Facilitating care coordination

The value of email for care coordination is supported by research. According to the Cochrane review, email has been employed in healthcare settings for diverse coordination purposes since the early 1990s, including consulting with colleagues, requesting prescriptions from pharmacists, referring patients between clinicians, and obtaining laboratory test results. The review notes that email's ability to create documented communication threads accessible to authorized parties can reduce miscommunication risks which is valuable for patients requiring input from multiple specialists.

The 2004 patient-provider study noted that 7% of patient messages provided reports about outside care received, showing how email facilitates care coordination across different providers. This email-based coordination creates a documented thread of communication that all authorized parties can reference, reducing the likelihood of miscommunication and ensuring continuity of care. For patients with complex conditions requiring input from multiple specialists, this coordination mechanism can be life-changing.

However, healthcare professionals must recognize email's limitations. As Ginn notes, "as text-only communication, emails can lack the nuance of face-to-face interactions as the emotive cues from vocal intonation or body language are lost." For complex care coordination involving sensitive decisions or nuanced discussions, email should complement rather than replace direct communication.

5. Improving patient education and follow-up

Healthcare providers are using inbound email to create more structured patient education workflows. After a diagnosis or procedure, patients receive a series of educational emails that they can respond to with questions. These responses help providers determine patient understanding and identify those who may need additional support.

The 2004 research demonstrated that 94.5% of patient messages were directly medical-related, with tone analysis showing that 84% of messages were concise and 63.7% were courteous. The study concluded that "physicians' concerns about using e-mail in clinical practice may be unwarranted," as patients largely adhered to guidelines about appropriate email use when provided with clear instructions.

Follow-up care has also been transformed. Instead of relying solely on scheduled follow-up appointments, providers can send check-in emails asking about recovery progress, medication side effects, or symptom changes. Patients' responses trigger appropriate workflows, whether that's scheduling a follow-up visit, adjusting medications, or documenting positive progress.

Read also: Why email is the best complement to conventional healthcare

Managing email effectively

While inbound email has a lot of benefits, healthcare organizations must address its challenges. Andrea Palm, Deputy Secretary of Health and Human Services, warned in the Paubox report,  "Cyber attacks are an increasing threat to the Health and Public Health (HPH) sector. These attacks can directly compromise patient safety."

Despite email accounting for half of all cybersecurity threats, healthcare organizations currently allocate only 11-20% of their IT budgets to email security, according to the Paubox report.

Ginn's research says, "email has not just changed the way we communicate but also the way we get things done." Furthermore, the Cochrane review outlines both advantages and limitations of email in healthcare settings. On the positive side, the review identifies email's capacity for timely and cost-effective information delivery, convenience allowing messages to be sent and read outside traditional office hours, creation of written records that aid recall, and facilitation of communication that might not otherwise occur.

However, the review also notes concerns that align with Ginn's warnings about privacy and confidentiality risks, potential for increased workload given the depth of content email permits, medicolegal issues particularly around non-encrypted communications, inappropriateness for urgent situations since emails may not be read immediately, loss of emotional cues present in face-to-face or telephone interactions, and technical challenges including full inboxes and system failures.

The solution lies not in abandoning email but in using it strategically while addressing security gaps. Ryan Winchester, CareM Director of Information Technology, emphasizes the reality in the Paubox report, "No amount of training can completely eliminate human error, so businesses must have safeguards in place." This is urgent given that the Paubox report found 89% of healthcare IT leaders believe AI and machine learning are critical for detecting email threats, while 84% say email automation improves both security and efficiency.

Ginn's research suggests that "employees reporting problems with emails are not necessarily those who receive or send the most emails but rather those who have not developed an effective structure for filing incoming emails." Furthermore, "less frequent inbox checking has been found to be associated with reduced stress and to predict greater well-being."

Healthcare organizations should implement protocols for email use, including:

• Guidelines distinguishing appropriate vs. inappropriate email topics
• Training on efficient email management techniques
• Integration of email with other clinical systems to reduce fragmentation
• Clear expectations about response times to prevent constant inbox monitoring
• Alternatives to email for urgent communications

Learn more: Inbound Email Security

FAQs

How does inbound email differ from traditional patient portals?

Inbound email allows patients to communicate directly through standard email clients, while portals require login access to specialized systems.

How does inbound email support telehealth services?

Inbound email enhances telehealth by enabling patients to send pre-consultation information, follow-up questions, and documents securely.

How can healthcare organizations train staff for effective inbound email use?

Regular training should cover HIPAA compliant practices, phishing awareness, and appropriate email tone for patient interactions.

Does inbound email improve patient satisfaction scores?

Studies show that timely and personalized email communication can improve patient satisfaction and trust.

Can inbound email reduce healthcare costs?

Yes, by automating administrative workflows and reducing phone-based communication, email can lower staffing and operational expenses.