Since the advent of penicillin and eventual demise of archaic blood-letting, medicine has made great strides into the future. From genome mapping to the $88K robo-docs used in the UK, (1) medicine is continually adding health and longevity to our years.

Tied in with these advances is our ability to connect with our physicians. According to a 2002 Harris Interactive poll, approximately 90% of adults with internet access would like to communicate with their doctors by email (2). Additionally, 37% of those would be willing to pay out-of pocket to communicate with their doctors online (3). If patients are seeking the next best thing to a house call, emailing your doctor could be just that.

Unfortunately, with the growth of phishing, malware, and spyware, accidental sending or forwarding a patients personal/private health information (PHI) could result in that identifying information being used in various sorts of fraud.

Protecting a patient's PHI is a deep-rooted tenet within the medical profession. Laws like the Health Insurance Portability and Accountability Act (HIPAA) ensure that medical facilities and clinicians protect their patients PHI.

In a 2005 study 70% of Americans are concerned that their PHI could be disclosed as a result of weak data security (4). With each technological advance, both the medical field and patients must be aware of the severity of improper use of PHI. According to the Heath Privacy Project, a patients rights information site, one in five patients are victims of improper disclosure (5).

In spite of all these risks, patients continue to utilize email and the internet in order to seek out answers to various personal health questions.

Online resources such as WebMDs Symptom Checker provides possible answers to patient maladies such as why their left leg is swollen. Others seeking medical information spend time at sites such as the American Diabetes Association, Alzheimer's Association or Lupus Foundation, and other sites that are strictly devoted to specific health issues. Patients often research illnesses online and want to ask questions about their conditions after clinics are closed.

Advocates of a digital medical office are doctors Tom Delbanco, MD and Daniel Z. Sands, MD, MPH. Both are professors at Harvard Medical School and have stated that email as a clinician tool fosters a closer doctor-patient relationship. In a co-authored paper, they write:

E-mail gives doctors and patients more time to think. Doctors and patients move closer together and trust grows strikingly. Interchange becomes more personal and office visits seem more efficient and less emotionally charged And with time off-line to reflect and learn, patients appear better able to grasp information that is central to their care. (6)

Its a matter of both convenience and comfort level, continues Dr. Delbanco, There's evidence that people tend to be more open in front of a computer, especially with tricky stuff.

The internet has changed where and how patients seek the help of doctors and medical providers. Trends in patient internet behavior show that now is the opportune time for both patient and doctor to achieve a cooperative relationship via email and the internet. Creating the digital medical office is a true possibility, but measures need to be put into place to protect patients private health information and a clinics electronic medical records (ERM).

The e-medical caregiver can converse with his or her patients in a wide array of online communications tools, continuing the symbiotic relationship between doctor and patient. The Hippocratic Oaths tenets of treatment, respect and privacy can be upheld as long as electronic security is also a priority to clinicians.

HIPAA compliance issues can often be frustrating to the small clinical practice. New government mandates are also putting regulatory procedures to the test, such as President Bushs request that $125 million in 2006 go to the U.S. Department of Health and Human Services to create common standards for digital health information by streamlining data and finding means to best protect patient privacy (7).

Investing in a Small Business Rights Management (SBRM) solution can bridge the gap between staying current with health industry regulations such as HIPAA or JCAHO (Joint Commission on Accreditation of Healthcare Organizations) and keeping a small physician practice in business. More importantly than compliance is the real protection of patient/client information, diagnosis/treatment communiqu, and medical billing information. Only the intended recipient will see this information when sent with tools that use encryption and rights management.

With SBRM solutions, a physician can apply the Hippocratic Oaths creed of confidentiality and privacy by clinic visit or email.

1.) Julie Clothier, CNN Technology, Robo-doc works hospital rounds, CNN.com 18 May 2005

2.) Harris Interactive, Patients/Physician Online Communication: Many Patients Want it, Would Pay for It, and Would Influence their Choice of Doctors and Health Plans. 10 April 2002,

3.) Ibid.

4.) Majority of Americans Have Privacy Concerns about Electronic Medical Record System, Health Privacy Project : http://www.healthprivacy.org/

5.) Health Privacy Project Homepage Animation http://www.healthprivacy.org. 29 September 2005.

6.) Health and Medicine Week / NewsRx.net Editors Choice Column, TELEMEDICINE: Physicians, patients must work on new electronic relationships, Health and Medicine Week, 5. 10 May 2004,

7.) Rick Callahan, The Associated Press Seattle Times, 23 May 2005