Why email is the best complement to conventional healthcare

Patients prefer email for convenience, with 93% wanting to communicate with providers via email. Email can facilitate efficient communication beyond the constraints of face-to-face visits or telephone calls. Unlike phone calls, emails provide a written record that both parties can refer back to, enhancing clarity and reducing misunderstandings. 

One study on the evolution of email in the management of gastroenterology patient treatment published in the Canadian Journal of Gastroenterology and Hepatology noted, “E-mail correspondence between physicians and patients can be a useful tool to improve communication efficiency, provide economic and ecological benefits, improve therapeutic interventions and adherence, and enhance self-management.” 

Email supports multidisciplinary care coordination by allowing various providers within an Organized Health Care Arrangement (OHCA) to share information securely and efficiently. Given the increasing demand for healthcare services and the limitations of traditional methods, email offers a scalable solution that improves access, reduces unnecessary appointments, and enhances patient engagement, making it an indispensable complement to conventional healthcare delivery.

Why conventional methods alone are no longer sufficient

Conventional healthcare communication methods, primarily in-person visits and telephone calls, are increasingly inadequate in meeting the demands of today’s healthcare environment. Rising patient volumes, provider shortages, and the complexity of chronic disease management have strained traditional communication channels. 

Telephone calls often result in phone tag, delays, and missed opportunities to address patient concerns promptly. According to the Cambridge University Press journal article ‘Email in healthcare: pros, cons and efficient use,’ “Messages can be sent and subsequently read at an opportune time, including outside of traditional office hours…can be used as reference information for the recipient, aiding recall and providing evidence of the exchange.”  In-person visits can be costly, time-consuming, and inconvenient, especially for patients with mobility issues or those living in rural areas.

Email vs. other digital tools

Email outperforms portals due to familiarity, higher engagement (60% open rates vs. 20% for portals), and no need for separate logins. While patient portals and mobile health apps have gained popularity, email remains superior in several key aspects, particularly in terms of user engagement, accessibility, and ease of use. 

Patient portals often suffer from low adoption rates due to usability challenges, the need for separate logins, and limited interoperability with other health systems. Many patients find portals cumbersome, leading to underutilization of their features. In contrast, email is a universally familiar platform that requires no additional training or software installation, making it accessible to a broader demographic, including older adults and those with limited digital literacy. 

Email communications have higher open and response rates compared to portal notifications or app alerts, which often get overlooked or disabled. Email can be integrated seamlessly into existing clinical workflows and electronic health records (EHRs), facilitating efficient provider-patient interactions without fragmenting communication channels.

How email reinforces messages beyond the exam room

Beyond the confines of the exam room, email serves as a powerful tool to reinforce clinical messages, promote patient education, and support behavioral change. ‘Email consultations in health care: 1—scope and effectiveness’ research study published in The BMJ notes, “Patients endorsed the use of email for straightforward issues such as communication of cholesterol test results or a normal cervical smear test result…Email was the preferred way of dealing with relatively minor problems such as a sore throat or back pain.”

Providers can use email to deliver tailored educational materials, such as videos, articles, or interactive content, which enhance understanding and retention of health information. Email reminders for medication adherence, preventive screenings, and lifestyle modifications have been linked to improved health outcomes across various populations. 

Email communication allows the delivery of sensitive or stigmatized health information in a less intimidating format, encouraging patients to disclose concerns they might withhold during face-to-face visits. Automated email campaigns can also maintain engagement over time, supporting chronic disease self-management and preventive health behaviors.

The administrative and operational benefits 

Email decreases the volume of inbound telephone calls, freeing staff to focus on more complex tasks and reducing wait times. It streamlines routine administrative processes such as appointment scheduling, prescription refill requests, and insurance verification, which traditionally consume considerable staff resources. It also allows for better documentation and audit trails of patient interactions, supporting compliance with regulatory requirements and quality improvement initiatives. 

From a cost perspective, email exchanges are far less expensive than phone calls or in-person visits, with some estimates suggesting savings of $10–$15 per interaction. Email also enhances care coordination by enabling rapid information sharing among multidisciplinary teams, reducing duplication of tests and procedures. The ability to send batch communications (e.g., health alerts, vaccination campaigns) supports population health management efforts.

Addressing barriers and provider concerns

A JMIR Medical Education study, ‘Email Use Reconsidered in Health Professions Education: Viewpoint,’ “Recommended caution relative to privacy concerns and the potential for miscommunication due to the nonverbal email format (n=9, 47%).” Unencrypted email transmission poses risks of unauthorized access to Protected Health Information (PHI), potentially resulting in HIPAA violations and costly data breaches. Studies indicate that a substantial portion of healthcare data breaches stem from insecure email practices. 

To address these challenges, regulatory updates such as the recent HIPAA Security Rule’s Notice of Proposed Rule Making (NPRM) emphasize stricter encryption requirements, mandate business associate agreements (BAAs) with email vendors, and call for enhanced risk assessments. HIPAA compliant email platforms like Paubox have emerged as practical solutions by providing encryption that does not require patients to use special portals or passwords, thereby maintaining ease of use while ensuring security.

Email, AI and interoperability

The convergence of email, artificial intelligence (AI), and interoperability promises to transform email into a highly intelligent, integrated communication tool that enhances conventional treatment plans. This is already noted in the field of email marketing with a thesis by Regina Gaynullina stating, “Among many benefits that AI can provide, marketers agree that it can have a gamechanging influence on email marketing. About four in ten marketers reported that the implementation of AI in their email marketing efforts had a positive impact on their company's revenue.”

AI can analyze incoming emails to triage messages, prioritize urgent issues, and even generate draft responses, reducing provider workload and improving response times. 

Natural language processing (NLP) allows for clinical data to be extracted from emails, which can facilitate documentation and decision support. Interoperability standards such as HL7 FHIR allow email platforms to seamlessly exchange data with EHRs. This integration supports personalized, data-driven care by ensuring that emails reflect the most current clinical information. 

Predictive analytics can identify patients at risk of non-adherence or complications based on email interaction patterns, prompting proactive outreach. AI-powered chatbots embedded in email systems can provide 24/7 patient support for common questions, triaging issues before escalating to clinicians.

FAQs

Is regular email (like Gmail or Outlook) HIPAA compliant?

Standard Gmail, Yahoo Mail, and Outlook.com accounts are not HIPAA compliant by default. Even paid versions must be configured correctly, include encryption, and require a BAA to be HIPAA compliant.

Do I need patient consent to send emails under HIPAA?

Yes, patient consent or acknowledgment is required before sending PHI via unencrypted email. If the patient prefers unencrypted email despite the risks and gives written or documented consent, it can be allowed under HIPAA.

What types of emails are covered by HIPAA?

Any email that contains protected health information (PHI) is subject to HIPAA rules.