Dr. Arora cautions that the difference for hospitalists is that when a safety mistake is made with email, it can constitute a violation of the Health Insurance Portability and Accountability Act (HIPAA). And while those mistakes can happen innocently enough on social media or via text messaging, she says email issues are the most common.
“I’ve seen HIPAA violations where a patient would send an email to a doctor and the doctor would reply all to all of the [hospitalists] in their group saying, ‘Can anyone help me answer this question?’” she says. “So the forward email and forward and reply all are the most dangerous features because you have to know what you are forwarding and would that person want it shared with everybody.”
Landa believes that part of the problem with the efficacy of email is that it’s become so fast and so easy that people don’t take their time thinking about the impact of each email. Dr. Arora agrees and suggests hospitalists think carefully about what is in an email, particularly when it involves patient information.
“Share the minimum necessary information with a minimum number of people to try to accomplish what you are trying to do,” she adds. “That way, you are not clogging the inbox of everybody involved.”
Another potential pitfall to the efficacy of email is the “lost in translation” phenomenon, Landa says.
“How many times have you written am email and someone misinterpreted sarcasm or a joke or a particular word or a phrase and got upset because of what they thought you were saying?” he says. “I think that when you talk about the synchronous and rapid-fire style of the forms of communication, I think you elevate the risk by an order of magnitude. That’s the reason we have developed all the emoticons and all the visual references that are out there—to make sure that people don’t misinterpret what we’re saying.”
What’s Old Is New
So if hospitalists and communications experts believe email retains a place in the way information is conveyed, why is the question of its impending death a continuing parlor game for some?
“Because there’s always something new,” Moore says. “Because Messenger on Facebook looks a little bit flashier than email. Because now we have Periscope. Now we have Twitter. Now we have different types of platforms that message within each other. They all look flashier.”
But, in essence, each is simply a somewhat more modernized version, more bells and whistles, Moore says. He likes to compare it to the U.S. Postal Service. As technology progressed and communication became more real-time in ways well beyond telephone conversations, many pundits forecasted the end of what is derisively called snail mail, itself an admission of the speed and efficacy of electronic mail.
“You could make the analogy between the death of email and the death of the U.S. mail,” Moore says. “Ten years ago, people were writing this article about the death of the U.S. mail. And it certainly changed. Yes, there are less letters and less traffic and less parcels that the post office sends. But it’s still there. It’s not going away; it’s just adapting in a certain way.
“If you want to pinpoint a time that there is ‘the death of email,’ I think the death of the U.S. mail comes before it.” TH
Richard Quinn is a freelance writer in New Jersey.