E-mail Communications between Patients and Healthcare Providers

Guidelines for Writing E-mails

When e-mailing your IWK healthcare providers, please do the following:

• In the Subject Line, clearly state your topic or type of request.  Some examples are:  “Appointment”; “Prescription Refill”; “Lab Results”; “Medical Advice Needed”, etc.).
• In the first line of the body of the e-mail (your message), type in the patient’s full name and identification (ID) number.  Some examples of ID numbers are:  hospital unit number; Health Card Number; Date of Birth (DOB).  For research study participation, use your Research Study ID #.
• Here are some examples of appropriate reasons to e-mail your healthcare provider:
  • You need to renew a prescription
  • You need non-urgent medical advice
  • *Test results, based on your healthcare provider’s professional judgment
  • You need to schedule, cancel, or   reschedule an appointment
  • You need to discuss Clinic or Healthcare Provider changes
  • Other non-urgent communication, such as asking for educational materials or resources. 
• Here are some examples of inappropriate reasons to e-mail your healthcare provider:
  • Urgent/emergency situations
  • New diagnosis questions
  • Test results (based on healthcare  provider’s judgment)
  • Asking for copies of your health record

The Risks of Using E-mail

To best protect your privacy and confidentiality, we do not recommend e-mail as your first choice to communicate with your IWK health care providers. Using e-mail to discuss patient information has a number of risks.  Patients (or their parents or guardians) should consider these risks before deciding to e-mail healthcare providers.

Some of the risks of using e-mail are:

• E-mail can be forwarded to the wrong person; it can be printed and saved as many paper or electronic copies; it can be copied and pasted to public websites.
• E-mail senders can misaddress e-mails very easily.  Make sure you print your e-mail address very clearly when writing it down for someone.  Avoid common mistakes.  For example, the number one (“1”) and lower case letter “L” (“l”) look the same.
• E-mail can be forged or changed without your knowledge.
• Backup copies of email may exist even after the sender and recipient delete their copies.
• Employers and on-line services have a right to save and read any e-mails that are sent through their systems.
• Hackers can use e-mail to send viruses to computer systems.
• E-mail messages are not encrypted (protected) on the hospital e-mail system and there should be no expectation that the email is encrypted in transit. The hospital cannot guarantee the security of messages that you send to, or receive from, your IWK healthcare provider(s).
• E-mail is a legal record.  Your e-mail messages can be used as evidence in court.
• Your IWK healthcare provider(s) may not respond as quickly to your e-mail as they would to a phone call or voice message from you. 

Conditions for Using E-mail with the IWK

The IWK Health Centre cannot guarantee the security or confidentiality of e-mail messages. If you e-mail confidential (private) patient information to an IWK healthcare provider, the IWK may not be responsible if your message is revealed in the wrong way (improper disclosure).  That is, if the improper disclosure was not the IWK’s fault:  for example, you included the wrong person or made a mistake in the e-mail address. 

Patients (or their parents or guardians) must agree with their healthcare provider that they can use e-mail to communicate with each other.  Patients (or their parents or guardians) then must consent (agree) to the following conditions (rules):

• Your IWK healthcare providers will print any e-mails that are important to patient care (whether they are e-mails sent to or from you).  These printed e-mails will be added to the patient’s medical record. Other IWK healthcare provider(s) will have access to these e-mails if they are authorized to see the medical record. 
• Your IWK healthcare providers may forward your e-mails to IWK staff or team members working within the IWK Health Centre.  Some reasons your e-mails may be forwarded have to do with: diagnosis, treatment, or billing.  The IWK Health Centre will not forward e-mails to outside organizations or people who are not part of IWK staff or teams.  The IWK will not do this unless they have your written consent beforehand.  Or unless they are authorized or required to by the law.
• The IWK Health Centre will try to respond to patient e-mails promptly - but we cannot guarantee we’ll answer your e-mail by a set time.  Patients should never use e-mail for medical emergencies or other time-sensitive matters.
• It is the patient’s responsibility to follow up on e-mails sent to or from IWK healthcare providers.  For example, scheduling appointments if needed.
• If a patient is waiting a very long time for the IWK Health Centre to reply to their e-mail, it is the patient’s responsibility to follow-up.  It is up to you to find out if the IWK received your e-mail.  You should ask the IWK when you can expect their reply. 
• The patient should not use e-mail to send private medical information to the IWK Health Centre. You should also let the IWK know if there is anything you do not want the IWK to e-mail to you. 
• It is the patient’s responsibility to tell the IWK Health Centre if there is a change to their e-mail address.  You should also tell the IWK if you no longer wish to discuss things by e-mail.
• The patient is responsible for protecting his or her own e-mail password.  You are also responsible for keeping your e-mail from being seen by other people who should not be reading it.   The IWK Health Centre is not responsible for a patient’s confidential information being revealed in the wrong way if.  For example, the IWK is not responsible if: 
  • you did not hide your password and someone else used it to access your e-mail, or
  • you used your e-mail at a public computer and others read your message because they could see it on the screen, or 
  • you forgot to log off your account when you left the computer and someone else brought your message back up on the screen to read.