Table 1.

Barriers to Online Communication Between Patients and Their Providers

Perspective	Barriers
Organizations	No direct payer reimbursement for online communication
	Technical and operational complexity
	Uncertainty about privacy, confidentiality, medicolegal issues
Providers	Concerns about being overwhelmed with messaging
	Concerns about relevance and appropriateness of messages
Patients	Little experience with online clinical communication tools
	Facility and use of online communication varies: those most “in need” may be least likely to be online