Table 3.

Findings on patients' use of and attitudes toward e-mail communication with providers.

Sources	Main findings
Anand et al. [10]	Of all the parents who returned survey, 93% were mothers and 86% had completed college. 98% were very satisfied with their e-mail communication with their pediatrician. 80% felt that all pediatricians should use e-mail for communication with parents and 65% would be more likely to choose a pediatrician based on access by e-mail; 63% were unwilling to pay for access.
Couchman et al. [16]	54.3% of patients reported having e-mail access, with significant variation among the clinics involved in the survey. Patients mostly desired to use the e-mail for requesting prescription refills, non-urgent consultations, and obtaining routine laboratory results or test reports.
Couchman et al. [17]	58.3% of patients had e-mail access, but only 5.8% reported having used it to communicate with their physician. Patients were most willing to use e-mail for requesting prescription refills (83%), followed by direct communication with their physician (82%), non-urgent consultations (82%), and obtaining routine laboratory results or test reports (82%). High expectation of timeliness of responses. Significant differences of willingness and expectations by age group, education, and income.
Houston et al. [18]	Users of e-mail with physicians in this survey were twice as likely to have a college education, were younger, were less frequently ethnic minorities, and more frequently reported fair/poor health than participants in the population-based Behavioral Risk Factor Surveillance Survey (BRFSS). Among those who used e-mail with their physicians, the most common topics were results of laboratory testing and prescription renewals. 21% of topics reported included urgent issues and 17% included sensitive issues. Frequently reported benefits of e-mail communication included the efficiency of communication, being more emboldened to ask questions and able to save the e-mail messages. Users expressed concerns about privacy.
Kagan et al. [19]	9.5% of patients reported actually using e-mail to contact their surgeon or nurses. About 30% of those who were not currently using e-mail with health professionals planned to do so within the coming year. The most common issues addressed by e-mail were symptom management and prescription refills. Family members were less interested in using e-mail than patients.
Katz et al. [20]	There were few differences between patients in e-mail group and control group in attitudes toward electronic communication or communication in general.
Katzen et al. [21]	Patients favored e-mail for increased convenience, efficiency, and timeliness for communication with their physicians about general health problems. 80% of respondents favored posing a health-related question to their physicians over e-mail. 51% of patients were concerned about overall confidentiality of physician-patient e-mail communication.
Kleiner et al. [22]	Parents aged 31–40 years were significantly more likely to have access to e-mail. E-mail access was higher for those with higher family income or higher parental education. 74% parents expressed interest in using e-mail to contact their child's physician/physician's office for getting information or test results, scheduling appointments, and/or discussing a particular symptom. Parents at the general pediatricians offices were significantly more concerned about confidentiality than those at subspecialty pediatricians offices.
Leong et al. [11]	Compared with patients in the control group, those in the e-mail group showed higher level of satisfaction the areas of convenience of communicating with their physician and the amount of time spent contacting their physician.
Moyer et al. [23]	Among the self-defined e-mail users, only 10.5% of them had ever used e-mail to communicate with their doctors. 70% of all patients said they would be willing to use e-mail to communicate with their doctors. Overall, patients were concerned about logistics (e.g., whether the message would get to the right person, how long it would take to get a response).
Rosen and Kwoh [12]	86% strongly agreed or agreed that e-mail increased access to their children's doctors. 84% strongly agreed or agreed that more physicians should offer e-mails.
Schiamanna et al. [24]	The likelihood of access to a provider who did e-mail consults were greater for patients who visited primary care providers, for patients seen in the west, for patients aged 45–64, for male patients, for nonminority patients, for patients seen for pre-postsurgical care, and for those who saw a physician instead of a nurse in addition to a physician.
Sittig et al. [25]	6% of the patients in the survey had actually sent an e-mail message to their provider. Identified main issues that prevented patients from sending e-mail messages to their providers included not knowing their provider's e-mail address and concerns that someone other than their provider may read the message. When being told that their e-mail messages might be read for screening, over 33% patients were worried that their messages could be intercepted and read by unauthorized people.
Virji et al. [26]	80% of patients who used e-mails were interested in using e-mail to communicate with the clinic. 42% were willing to pay an out-of-pocket fee for e-mail access to their physicians.