According to a Cross-Sectional Survey on Older Patients’ Enthusiasm to Use Electronic Mail to Communicate with Their Physicians, “Older patients would likely benefit most from electronic correspondence with their physicians.” This raises the question of how email can make it easier for older patients to communicate with their doctors.

Some patients may simply appreciate receiving a reminder about their appointment. Older patients who have difficulty hearing clearly on the telephone may prefer to receive an email reminding them of their appointment. This could also be helpful for caregivers who look after their spouses, as they may be able to request prescription refills on the patient's behalf when authorized to do so. Patients may also appreciate having written instructions they can refer to if they experience memory difficulties.

 

Why older patients want to use email

In the above-mentioned survey, only 1.3% had emailed their doctors while 49.3% of patients were enthusiastic about the possibility. This suggests that even though relatively few patients were using email, many were interested in the idea.

A patient who has visited their doctor to discuss a new medication may struggle to remember everything they discussed. They may not remember whether they need to take their medication before or after food. An email with clear instructions would give them something to refer to later. Furthermore, “Because email adoption could potentially reduce some of the disparities faced by this age group, there is a need to understand factors determining older patients’ enthusiasm to use email to communicate with their physicians.”

Patients may also appreciate using email if they find it difficult to visit the clinic for minor queries. They may want to confirm when their follow-up appointment is scheduled or ask about a routine test. Given the ubiquity of email, this is an excellent way for these patients to communicate with their healthcare providers.

 

Benefits to older patients

Email allows patients to read information when it’s convenient for them. This can be helpful for those who struggle to remember everything they were told over the telephone.

More specifically, healthcare organizations can use HIPAA compliant emails to send elderly patients appointment reminders with their next appointment date and time. These emails can also include instructions, like whether they need to fast before an appointment or bring specific documents, helping patients prepare.

Email can also give patients more time to think about their questions, especially if they struggle to explain their concerns in a short amount of time. If they feel anxious or have several concerns to discuss, this can become even more difficult. These elderly patients can then reply to the secure emails with a question, like What are the side effects of my medication.

Healthcare organizations can also send patients educational resources to help them understand their condition. For example, if a patient has recently been diagnosed with high blood pressure, they may receive an easy-to-read leaflet explaining how to measure their blood pressure at home. The message can also explain when they should contact the organization for further guidance.

 

Challenges older patients may face

Not all patients will be able to use email comfortably, especially if they have different levels of experience with technology. Age alone does not show whether someone will find email easy to use, but HIPAA compliant emails can be customized if patients struggle with small text due to poor eyesight. Additionally, healthcare providers must use simple language that’s jargon-free and easy to read. Secure emails should also include follow-up information, like how to contact the organization to schedule a follow-up appointment.

 

Making it easier for older patients to use email

Accessibility

Healthcare providers must find out whether their patients regularly use email and feel comfortable receiving healthcare-related messages. These questions can be asked during the initial patient intake, and providers must check whether their circumstances have changed over time.

HIPAA compliant emails should also be tailored to be viewed on different devices, like a smartphone or a tablet. Therefore, keeping messages short, dividing information into sections, and placing the main instruction near the beginning would be helpful. Some older patients may have a caregiver who can help them with technology. However, healthcare staff should respect the patient's independence and follow applicable privacy requirements before sharing their healthcare information with family members or caregivers.

 

What to do in case of an emergency

Patients must be informed that email is not the best option in case of an emergency, and how long it may take for a provider to reply to an email. Providers can include their specific office hours in their email signature and alternative contact details in the event of an emergency. For example, if an elderly patient has suicidal thoughts, they must be able to easily find the 988 Suicide & Crisis Lifeline on the provider's email signature. Patients should also be told that if they experience urgent symptoms, they should use an appropriate urgent-care service or visit the nearest emergency department rather than waiting for an email response.

 

Maintaining patient privacy

Any messages containing identifiable patient health information should be handled according to the applicable privacy requirements. In the United States, healthcare organizations are subject to HIPAA law, making them liable for safeguarding individuals’ protected health information (PHI) under HIPAA’s Privacy, Security, and Breach Notification Rules.

Older patients may be concerned about who can view their messages, particularly if they use a shared computer. In such cases, healthcare staff can explain how their information is protected and show them how to use two-factor authentication (2FA).

HIPAA compliant platforms must sign a business associate agreement (BAA) which outlines the responsibilities of the covered entity and business associate. However, signing a BAA does not automatically make every aspect of an organization's email practices HIPAA compliant.

Caution is advised with subject lines and message content. A subject line such as “Follow-up appointment” generally reveals less information than one that refers to a diagnosis or sensitive treatment. Providers must keep messages relevant to their purpose and adhere to HIPAA’s minimum standard. They should also avoid including unnecessary clinical details in the email body and verify recipient addresses before sending messages to prevent accidental PHI disclosure.

 

Best practices for sending emails to older patients

Healthcare organizations should develop policies for sending emails to patients. These can include using specific templates, designed with simple messages, clear instructions, and short paragraphs. Healthcare staff should also use familiar words where possible and explain medical terminology when needed.

When a provider sends a follow-up message after an appointment, they might want to explain why the patient is being contacted and tell them what they need to do next. If they need to attend another appointment, the date and time must be easy to find, perhaps highlighted, in the email message.

For example, if a patient is due for their annual breast cancer screening, their provider can send a HIPAA compliant email with their next appointment date and personalized screening recommendations based on their individual risk profile. A clear, personalized follow-up message can help patients understand why they are being contacted and when and where to attend another appointment.

Healthcare providers should also encourage patients to ask questions if they do not understand an email or its instructions. For example, a provider could include a telephone number that patients can call to clarify appointment details or discuss screening recommendations. They can also offer to provide additional guidance when patients need clarification.

Healthcare organizations must regularly train their staff members on communicating with older patients through email. Staff should understand how to adapt their communication to accommodate different levels of digital literacy and cognitive difficulties. They should also avoid assuming that all older patients have the same communication needs, as preferences and abilities can vary. Healthcare organizations should also do their best to protect older patients from phishing attempts and email scams. These organizations should explain how patients can recognize legitimate communications from their providers and avoid sharing sensitive information in response to suspicious messages. Providers should also check that email addresses are accurate and explain how patients can contact their healthcare organization if they have concerns.

Related: Introducing Paubox Security Awareness Training

 

FAQs

How can healthcare providers address elderly patients’ reluctance to share personal information?

Providers must build trust with elderly patients by explaining HIPAA safeguards, their organization’s privacy protections, and how they use a HIPAA compliant email solution, like Paubox, which uses advanced security measures to safeguard patient information.

 

Do providers need patient consent for HIPAA compliant emails?

Yes, a provider must get explicit patient consent before sharing their PHI through HIPAA compliant emails and document their communication preferences. HIPAA also requires providers to accommodate reasonable requests for alternative communication methods, like telephone calls.

Learn more: A HIPAA consent form template that's easy to share

 

Are standard emails secure for discussing sensitive healthcare information?

No, standard emails do not provide the necessary encryption to protect sensitive healthcare information from potential breaches. So, providers must use a HIPAA compliant email platform, like Paubox, to safeguard patients' protected health information (PHI) during transmission and at rest.