What E-MAIL Can Add to Your Practice
When used appropriately, e-mail can be a productive patient communication tool.
BY WILLIAM B. RABOURN, JR.

The majority of ophthalmic practices already have some Internet/ e-mail capability, but most haven't yet learned how to harness this capability to create important benefits for both the practice and its patients.

Recently, I've heard many ophthalmologists worry that they're being left behind --that their practices aren't using this powerful tool to its full advantage. If you count yourself among the worried, perhaps it's time to do something about it.

In the business world, e-mail is fast becoming the rule of communication, as necessary as a fax machine or telephone. E-mail can be used to send any computer-based communication, including attachments, photographs, Internet links, programs and electronic documents.

Some of the leading ophthalmic practices have quickly caught on, and are using e-mail as a tool of convenience to communicate with patients in innovative ways.

Many practices have found that e-mail is far less costly than using the postal service and, in certain instances, much more efficient than tying up telephone lines to convey routine messages or to answer patients' questions. E-mail is simple, fast and results in a clear, written message that a patient won't be likely to misinterpret or forget. And unlike a phone conversation, an e-mail message can be saved so that a patient can refer to it if that becomes necessary.

In this article, I'll first look at how you can determine whether e-mailing fits into your practice. Then, I'll tell you how you can get started using it appropriately in a number of ways as a productive patient communication tool.

Because of the flexibility and diversity that e-mail offers, ophthalmic practices can utilize it for a variety of purposes, including:

Patient communication. In basic physician/patient communication, e-mail can be used for prescription reorders, pre- and postoperative instructions, and providing answers to patient questions.

Appointment reminders and practice information. Using e-mail to convey appointment reminders and practice information enables the practice to keep in touch with patients while eliminating the cost of postage and stationery traditionally used for such purposes.

Public service announcements. Public service announcements allow the practice to announce changes in office hours, introduce new employees, provide information on practice locations and discuss expanded patient services.

Press releases. Press releases are useful in notifying various media sources of newsworthy events in your practice, including staff expansions, new procedures that you're offering, and any meetings or seminars that you're holding to which the public is invited.

Advertising and direct offers. Advertising through e-mail can also have a highly positive impact on your business. You can embed hyperlinks in your e-mail messages that will direct traffic to your practice Web site. You can also use e-mail to send a newsletter to patients, or to promote the practice and its services.

Patient forms. Practice forms can be sent to patients prior to their appointments. This will allow patients to fill out the forms in advance, enabling your front desk staff to be more efficient.

Getting Started in E-Mail

The critical first step in using e-mail as a patient communication tool involves making the decision to set up your own e-mail program and determining how you'll use it in your practice. Can e-mailing benefit your practice? If so, how much do you want to invest? And how extensive a system will you need? To determine how e-mail might fit the specific needs of your practice, start by asking yourself these three questions:

Do I really want to use e-mail as a patient communication tool in my practice? Don't fall in line just because it seems as though everyone is using e-mail. If you don't have buy-in from the beginning, the program will fail. If e-mail doesn't fit with the current practice philosophy and business model, then don't use it, or else start thinking about how to fit it within your business model.

What's my patient demographic? You'll need to start building your e-mail address list by approaching your current patient base. You can probably make an initial determination of how successful an e-mail program could be by simply asking your patients if e-mail is a service they'd like to receive. If you have a primarily senior population, there may not be enough e-mail addresses to justify the development of the e-mail program. However, the current number of seniors in the United States who use e-mail is 7.6 million and growing, so be careful not to make assumptions. It's better to simply ask your patients. A vast majority of baby boomers use e-mail, and many of them will enter the senior demographic in the next decade.

What about a practice Web site? If you don't have a Web site, consider building one. A Web site and e-mail program should work together to attract and retain patients. The Web site can serve as a good resource for potential and existing patients to gather information on your practice and its physicians. You'll be able to include your Web site link with every e-mail you send out to a patient. This will generate more Web site activity, which will stretch your Internet dollars in the long run.

Make sure all e-mail communication comes from your practice e-mail, such as doctor@abceyecenter.com. A personal e-mail account such as Hotmail or AOL won't look as professional to a patient.

Implementing Your E-Mail Program

The basic technology you'll need to start e-mailing is a computer system with an e-mail program such as Microsoft Outlook, and some form of Internet access. A number of different Internet access and e-mailing programs are available in the market. If you purchase an e-mail program, make sure that patient information is protected under the same strict standards you've set up in your office. If you already have a Web site, then your Web host will be able to help you set up your online patient database.

You already have a receptive audience in your existing patient base. These people know you and are likely to readily accept your e-mails. But don't just start pressing the "send" button. The best way to introduce patients to your e-mail messages is through "permission-first marketing," or simply "permission marketing."

The goal of permission marketing is to ensure that a patient never thinks of your e-mail as unwanted "spam." To obtain permission from your patients, it's important to follow the following three rules:

Add a space for an e-mail address to your patient information forms. This makes giving permission convenient for the patient. E-mail addresses are becoming as common as physical addresses and should be treated with the same prominence on patient information forms.

Include a disclaimer stating that each patient's e-mail address is part of his or her personal file and will be kept strictly confidential. Web-savvy Internet users have multiple e-mail addresses and usually offer companies who ask for their e-mail an address that they seldom check. When you include a privacy statement to assuage the fear of spam, the patient is much more likely to offer a primary e-mail address.

Get permission to market. If you plan to market to the patient, include a checkbox asking for your patient's consent to e-mail occasional updates and offers from your practice.

If you have an active Web site, you may utilize your Web site "contact us" page as a double opt-in Web form. This allows patients to supply their contact information and check a consent statement electronically, giving permission for the practice to e-mail the patient. You may also send a direct mailing to your patient database notifying them of this new service and directing them to your Web site for this double opt-in form.

Develop E-Mail Controls

A major concern for most practices and physicians when using e-mail is patient confidentially. To be HIPAA-compliant, a practice needs to develop a protocol for its e-mail communication with patients. Ensure limited access to patient information by assigning employees their own passwords to gain access to computer systems containing the e-mail addresses.

Develop a special staff team to manage your patient e-mail initiative, institute protocols, answer e-mails, and provide administrative guidelines for e-mail communications. This team should establish what will and won't be allowed in terms of e-mail communication. Make sure that all staff and patients understand these guidelines.

Examples of acceptable e-mail subject matter could include appointment scheduling, billing questions and office announcements. Unacceptable e-mail subject matter may include mention of private medical records or patients' medical histories.

Determine what the expected patient e-mail response time should be and decide what types of e-mails will be sent to all patients. These "mass" e-mailings could include such communications as the practice newsletter, or messages promoting the practice and its physicians.

Used effectively, e-mail can help "brand" your practice by keeping you in regular touch with your current patient base. And if you're sending advertising pieces, e-mails are easy for the receiver to forward to friends and family. Remember, word of mouth brings more than 60% of all patients into the average practice.

Monitor Your Results

But with every great idea and plan, you still need a follow-up process to ensure success.

Reporting systems are available through your Web site host. The Web host will be able to provide you with the number of e-mails sent, number of e-mails opened, and individuals who have unsubscribed (opted out) of your e-mail communications. Reporting is even more important when you're using e-mail to send advertising messages.

If you think it makes sense to start communicating with patients via e-mail, now is the time to do so. Opportunities to use e-mail to reach patients are sure to continue to increase in the future as the number of e-mail users grows. If you wait 5 years to begin such a program, you may find that you're already far behind your competition in terms of effective patient communication.

E-mail will never take the place of efficient office personnel. No patient will ever e-mail concerning an emergency, and most patients will continue to prefer relating their problems to a human voice rather than an electronic message. However, e-mail as a communication tool can be invaluable for its inherent efficiency and ease. Adding e-mail to your practice can, and will be, an enjoyable experience if you approach it with a positive attitude and then begin to realize the benefits of such a program.

William B. Rabourn, Jr., is the founder of Medical Consulting Group, an ophthalmic consulting firm based in Springfield, Mo. You can reach him at (417) 889-2040, or via e-mail at bill@medcgroup.com