# The Use of E-mail in Primary Care: Characterization of the Reality of a Family Health Unit

## TL;DR

This study examines how email is used in a primary care setting, finding it's common for prescriptions and administrative tasks, but with low response rates and a need for better regulation.

## Contribution

The study provides a detailed characterization of email communication in a Portuguese family health unit, highlighting its role and challenges post-COVID-19 digitalization.

## Key findings

- Most emails were for prescriptions or test results, with a high proportion from users with higher education.
- Only 32% of emails received a response, and 11% led to in-person or phone consultations.
- The study emphasizes the need for regulatory frameworks and professional training to improve email communication in primary care.

## Abstract

Introduction

The progressive digitalization of healthcare has fostered the utilization of e-mail as a communication tool between users and family physicians. This modality has the potential to enhance accessibility, ensure continuity of care, and support clinical decision-making. Nevertheless, concerns persist regarding data security, equitable access, and increased workload for professionals. This study aims to characterize the use of e-mail communication within a Family Health Unit in Lisbon.

Methods

A descriptive, observational, cross-sectional, and retrospective study was conducted, based on the analysis of 1,282 e-mails sent by users to two family physicians between July and December 2021. Variables analyzed included user characteristics (sex, age, educational attainment), reasons for contact, response rate, and time, as well as the subsequent clinical or administrative outcomes resulting from the e-mail exchanges.

Results

Among the users, 71.68% were female, with a mean age of 48.2 years. Of the 390 users for whom educational data were available, 94.10% had attained higher education. The main reasons for contact were requests for prescriptions or test results (35.34%), administrative matters (14.66%), and repeat prescription requests (11.86%). Only 32.06% of the e-mails received a response, with a median response time of 2 days. Approximately 11% of the contacts led to in-person or telephone consultations, and 26.37% were documented in the clinical record.

Conclusion

The findings reflect an increased reliance on e-mail communication in primary care, accentuated by the digital transformation following the COVID-19 pandemic. The results underscore the necessity of establishing regulatory frameworks, providing professional training, and allocating adequate resources to ensure the safe, efficient, and equitable integration of this tool into routine clinical practice.