ACP releases ethical guidance for electronic communication with patients

The American College of Physicians (ACP) has released a position paper aimed at ensuring that electronic communication between patients and physicians are thoughtful and effective while also maintaining standards of ethics and professionalism.

According to a news release, the position paper, “American College of Physicians Ethical Guidance for Electronic Patient-Physician Communication: Aligning Expectations,” appears in the Journal of General Internal Medicine and was developed by the ACP Ethics, Professionalism and Human Rights Committee (EPHRC). It makes recommendations for physicians navigating these new forms of communication with an emphasis on ethics and professionalism, privacy and confidentiality, and price considerations.

While the paper looks at using email, patient portals, texting , and messaging applications used by patients and physicians, but does not examine telemedicine, telephone, video, or other applications; or communication between clinicians, the release says.

The recommendations for electronic communication in the position paper include:

• They should not take the place of in-person communications
• They should only take place after discussion with the patient about expectations and appropriate uses, and with the patient’s consent
• It should occur through a method that is patient-centered and secure such as a patient-portal
• These communications should be documented in the medical record
• If these communications are done with attention to ethical and other concerns, they can help improve patient care, satisfaction, and clinical outcomes
• Electronic communications should be used by physicians and institutions to promote health equity and proactively address the socioeconomic and demographic factors that can lead to disparities in uptake and utilization
• Physicians, patients, and institutions should recognize and address increased workload associated with electronic communication and the impact that can have on physician well-being

“This paper is particularly timely given the COVID-19 pandemic,” Jacqueline W. Fincher, MD, MACP, president of ACP, says in the release. “E-communications have become necessary and powerful tools that have the potential to help improve quality, patient satisfaction and access to health information and clinicians but they must be used with care and with clear and mutual understanding of patients and clinicians.”

The paper also notes that the ACP Ethics Manual says that physicians must act in the best interest of the patients and should take care to extend standards for maintaining professional relationships and confidentiality.