Provider-to-provider (P2P) inquiries in healthcare typically involve communication between medical professionals regarding patient care, referrals, test results, treatment plans, and second opinions. These interactions ensure continuity of care and improve patient outcomes.
In the study Provider-to-Provider Electronic Communication in the Era of Meaningful Use: A Review of the Evidence, Colin Walsh and colleagues state that “Coordination of care within a practice, during transitions of care, and between primary and specialty care teams requires more than data exchange; it requires effective communication among healthcare providers… Strong collaboration among providers has been associated with improved patient outcomes. Yet, despite the significant role of communication in healthcare, communication may not take place at all, even at high-stakes events like transitions of care, or it may be done poorly at the risk of substantial clinical morbidity and mortality.”
This demonstrates the need for structured, secure, and reliable channels, such as HIPAA compliant email, to support provider-to-provider inquiries. With the right tools and best practices, email can be a powerful facilitator of timely, coordinated care.
Strong inter-provider communication has been shown to directly improve patient outcomes, reduce redundant testing, minimize errors, and strengthen collaborative care. When healthcare professionals share timely, relevant information, they can coordinate interventions more effectively and respond to patient needs with greater accuracy.
The study Communication in healthcare: a narrative review of the literature and practical recommendations found that “poor communication can indeed lead to various negative outcomes: discontinuity of care, compromise of patient safety, inefficient use of valuable resources, dissatisfaction in patients and overworked physicians and economic consequences, often hidden.”
Despite these risks, P2P communication is often informal, inconsistent, or left to inefficient channels. By recognizing the value of secure, streamlined communication, especially through HIPAA compliant email, healthcare organizations can reduce these risks and promote better health outcomes across care teams.
While the content of provider-to-provider emails may vary based on specialty or setting, some common scenarios include:
Email has become a common tool for communication in healthcare, including P2P interactions. It offers convenience, speed, and documentation benefits, making it a preferred choice for sharing information about patient care, referrals, test results, and treatment plans. However, as highlighted in the BJPsych Advances article, “Email in healthcare: pros, cons and efficient use”, email also introduces a host of challenges that can compromise clinical efficiency, patient safety, and regulatory compliance if not carefully managed.
Email reshapes clinicians' workflows, often interrupting critical tasks mid-course. Studies show it can take up to 15 minutes to refocus after addressing an email interruption, and professionals frequently multitask by responding during meetings. This can shift priorities from important clinical tasks toward urgent email requests. Additionally, the indiscriminate use of CC and “reply all” can lead to endless email chains that generate even more workload.
Emails often intermix diverse topics, clinical updates, administrative matters, and scheduling, all in the same inbox. This can obscure key messages and create confusion. Email also lacks emotional nuance and nonverbal cues, leading to ambiguity and a potentially unprofessional tone. Furthermore, without a clear structure, emails may fail to communicate expectations or urgency effectively.
Standard email systems lack built-in protections for PHI, leaving sensitive patient information vulnerable during transit or storage. Confidentiality breaches, including misdirected emails or unauthorized access, can lead to HIPAA violations and liability. Many healthcare organizations lack strict audit trails or access controls, increasing risk.
Clinicians encounter "technostress"—a combination of techno-invasion, overload, complexity, unreliability, and insecurity. They may feel pressured to be constantly available, juggle complex platforms, and adapt to frequent system changes. These factors can contribute to burnout and reduced job satisfaction.
Email exchanges do not automatically become part of the clinical record. This decentralized documentation pattern risks essential information being missed or not integrated with electronic health records (EHRs). Poor integration and inconsistent retention of emails pose safety hazards and clinical inefficiencies.
Without clear policies, staff may send emails that are inappropriate for the medium, urgent matters, complex medical decisions, or emotionally intense updates. Emails may be misinterpreted, delayed, or ignored, especially when urgency is unclear. This can harm collaboration and delay patient care.
The convenience of email makes it easy for staff to overuse it for frequent updates, non-urgent questions, or administrative requests. This can create information overload and shift focus away from important clinical priorities. In large organizations, each unnecessary email can amount to significant lost time across the staff collectively.
Though individual emails are low-carbon, their vast volume contributes to greater overall digital infrastructure energy consumption. While not directly impacting clinical practice, this hidden cost reflects broader organizational resource use and sustainability concerns.
A study published in the National Library of Medicine found that “internal communication as experienced among healthcare professionals was overwhelming and insufficient at the same time. It created an environment promoting closer collaboration among different specialists and suggestions for necessary improvements.” Here are some best practices to consider:
Regular email services (e.g., Gmail, Outlook) do not automatically encrypt messages. Healthcare providers should use HIPAA compliant email platforms like Paubox. These offer encryption, access controls, and audit logs to ensure secure communication.
Encryption protects sensitive data by converting it into unreadable code that can only be accessed by authorized recipients. Providers should use email services with built-in encryption or attach encrypted files when sending protected health information (PHI).
Read also: Understanding the difference between secure and encrypted email
Before sending an email containing patient data, double-check the recipient’s email address to avoid misdirected messages. Implementing an internal validation process (e.g., requiring confirmation before sending PHI) can help prevent errors.
To reduce exposure, limit the amount of PHI shared in the email body. Instead, reference patient numbers or use secure attachments. If discussing a case, avoid including full names, birth dates, or Social Security numbers unless absolutely necessary.
When sending medical records or other sensitive files, use password-protected PDFs or documents. Send the password separately via a secure channel (e.g., a phone call or text message) to minimize risk.
A disclaimer in your email footer can reinforce privacy policies and compliance expectations. Example: "This email may contain confidential and protected health information intended only for the recipient. If you are not the intended recipient, please notify the sender immediately and delete this email."
Regular training on secure email practices ensures that all healthcare professionals understand compliance requirements, recognize phishing attempts, and avoid accidental breaches.
Paubox Email Suite is a HIPAA compliant email encryption solution that ensures secure healthcare communication without requiring recipients to log into portals or use additional passwords. With seamless encryption for both inbound and outbound emails, Paubox protects PHI while maintaining ease of use for healthcare professionals. Its automatic encryption eliminates human error, making it an effective tool for P2P inquiries, including referrals, lab result sharing, and care coordination.
Email can be secure if it is encrypted and follows HIPAA compliance guidelines. Using a HIPAA compliant email provider is recommended.
Related: Is email secure enough to transmit medical records?
Under HIPAA, covered entities may share PHI for treatment purposes without prior patient consent. However, it’s still wise to inform patients how their data is used.
Double-check the recipient's email address and, if necessary, confirm their identity through a secure internal process before sending PHI.