Electronic Communication

Aya Halahleh
• Computers are playing an increasing role in nursing
practice.
• Many health care agencies are moving toward
electronic medical records where nurses document their
assessments and nursing care.
• Electronic mail (e-mail) can be used in health care
facilities for many purposes:
- To schedule and confirm appointments
- To report normal lab results
- To conduct client education, and for follow up with
discharged clients (Macon & Mendiola, 2008).
E-mail
• E- mail is the most common form of electronic
communication.
• It is important for the nurse to know the advantages
and disadvantages of e-mail and also other guidelines to
ensure client confidentiality.
Advantages
E-mail has many positive advantages.
- It is a fast, efficient way to communicate and it is legible
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- It provides a record of the date and time of the message
that was sent or received.
• Some health facilities provide information to their
clients on how they can reach, via e-mail, specified staff
members.
• This improves communication and continuity of client
care.
- E-mail promises better access, and one research study
indicated that half of Internet users would like to
communicate with a doctor online (Reid & Wagner,
2008).
- Evidence has shown that clients and health care
providers are willing to use Internet-based technologies
(Dixon, 2010).
Disadvantages
- One disadvantage or negative aspect of email is concern by
both clients and primary care providers regarding
- privacy,
- confidentiality,
- and potential misuse of information (Atherton, Sawmynaden, Meyer,
& Car, 2012).
- Protection of client privacy remains an issue when
transferring information electronically .
- The health care agency needs to have an e-mail encryption
system to ensure security.
- An agency may have its own system or outsource it to an
encryption service.
• Another disadvantage is one of socioeconomics.
• Not everyone has a computer, and even if people have
access to computers at, say, a public library, not everyone
has the necessary computer skills.
• E-mail may enhance communication with some clients but
not all clients.
• Other forms of communication will be needed for clients
who have limited abilities with speaking English, reading,
writing, or using a computer.
The use of e-mail will be avoided in the following
situations:
■ When the information is urgent and the client’s health could
be in danger if the client does not read it immediately.
■ When the information is highly confidential (e.g., HIV
status, mental health, chemical dependency).
■ When lab data are abnormal.

If the information is confusing and could prompt many

questions by the client, it is better to either see or telephone
the person.
Other Guidelines
• Agencies usually develop standards and guidelines for the
use of e-mail in health care.
Nurses / health care provider need to know their agency’s
guidelines about what can be sent to clients by e-mail.
- The client usually signs an e-mail consent form.
This form provides information about the risks of e-mail and
authorizes the health agency to communicate with the client at
a specified e-mail address.
- When sending e-mail, the nurse / health care provider can
identify in the subject line that the e-mail is important or needs
immediate attention (Granberry, 2007).
- Information sent to a client via e-mail is considered
part of the client’s medical record.
- Therefore, a copy of the e-mail needs to be put in the
client’s chart.
- E-mails, like other documentation in the client’s
record, may be used as evidence during litigation.
• E-mail is another form of communication that can enhance
effective relationships with clients.
• It is not, however, a substitute for effective verbal and
nonverbal communication.
• Nurses / health care provider need to use their professional
judgment about what form of communication(s) will best
meet their client’s health needs.