GeekPress forwards on an article from a doctor about why they tend not to use e-mail, etc.
When I first went live with my practice on September 24th, 2007, I received plenty of criticism regarding patient privacy and security. Many people questioned my compliance with HIPAA, a federal law the vast majority of physicians and institutions in America have to abide by in order to protect patients’ private health information (PHI). PHI is defined as any situation where there is an identifying factor (such as name or SSN) associated with a diagnosis. For example, John Smith is telling me about his seasonal allergy symptoms via AIM. Under HIPAA, if I were IM’ing with a patient using an unsecure chat application, like AIM, I could face thousands of dollars in fines. If I revealed this health information with criminal intent, I could face up to $250,000 in fines and 10 years in prison.
If I signed contracts with insurance companies and/or Medicare and submitted online claims to these companies I would have to abide by HIPAA. My entire practice would be illegal. I could not email, IM, text, or video chat anyone using the ubiquitous most popular communication apps (like AIM, gmail, etc.) without breaking federal law. They are not encrypted and considered not secure. I would be fined out of existence and, if argued in court, I could even face years of jail time.
If any of you are wondering why your own doctor doesn’t communicate with you using email, IM, and other ways that simply make sense in today’s world, wonder no further. They break federal law with every email and IM since the vast majority of physicians have contracts with insurance companies or Medicare.
Because the doctor in question doesn’t take insurance, he says doesn’t have to be HIPAA compliant — so he uses e-mail all the time, etc. Granted, legality aside, that doesn’t get around the potential ethical problem of someone chatting with him on IM, or seeing an e-mail, who shouldn’t (e.g., I sit down at my wife’s computer, glance at her e-mail, see an exchange with Dr. Smith about her going on birth control when I thought we were trying to have a baby … etc.).
Doctor e-mail, though, is pretty damned useful. Kaiser now has a secure e-mail service tied into their web system. Just as I can go online and sign in and order a prescription refill, or make an appointment, or check my lab results, I can also leave a message with my doc, and get a notification (by e-mail) to come back to the site when the doc has left a reply for me. Much more convenient than trying to play phone tag or my scheduling a visit. Not quite as easy as messages popping up in a chat window or in my Gmail account (and the interface is kinda sucky), but it’s pretty good, and as or more secure than anything else online. Spiffy stuff, and a good compromise between privacy and utility.