Secure web messaging between patients and doctors: Not well received

Although e-mail may be an efficient clinician-patient communication tool, standard e-mail is not adequately secure to meet Health Insurance Portability and Accountability Act (HIPAA) guidelines. For this reason, firewall-secured electronic messaging systems have been developed for use in health care.

The Kryptiq messaging system was implemented at an academic center and messages were monitored continuously and tracked.

In the 8 months after implementation, only 5 messages were initiated by patients in contrast to 2,363 phone calls.

Patients/families expressed strong interest in e-mailing but secure Web messaging was:

- less convenient than using the phone
- too technically cumbersome
- lacked a personal touch
- only by a handful of patients

One pediatrician on Twitter wants a simpler solution:

@Doctor_V (Bryan Vartabedian): Gimme an integrated, secure Tw like tool for doc to doc/pt comm - part of record.

Comments from Twitter:

@yejnes: My patients like it!


Secure Web Messaging in a Pediatric Chronic Care Clinic: A Slow Takeoff of "Kids' Airmail". PEDIATRICS Vol. 127 No. 2 February 2011, pp. e406-e413 (doi:10.1542/peds.2010-1086)

Medical practices using email with patients see their voicemail volume drop - email replaces inefficient phone tag. "We in health care can no longer sit back and say, "I don't do email with patients" - a doctor in WSJ, 2012.

Image source: Wikipedia, public domain.


  1. I agree with Davis -- this is not our experience at Kaiser. I do as many (or more) e-mails as phone messages each day. Patients love it.

  2. I don't have much experience with this, but did you see Ted Eytan's recent post about his visit to Kaiser Northwest: ? He commented there that they have people that actively work patients to reframe their understanding of their interactions with their doctors as something that continues at home, over the phone, over the email, etc. So it's not just by some magic in the Kaiser EHR system that makes it work for patients but something in the way their personnel system introduces that system to patients...

  3. This is certainly the future. I think right now a large percentage of the generation that requires the most medical attention is not using technology like the younger generation. In 15-20 years, this will be the standard. By then, I'm sure they will have a way to make Skype-like calls "safe", let alone emails.

  4. We're a 6-physician practice in Irving, TX, and have 4,700 patients actively using our Kryptiq patient portal and secure messaging. They schedule appointments, ask questions, refill prescriptions, and get lab results. It's substantially improved our office efficiency, and has opened our staff to take more calls from potential new patients.

    The reality is, if you let your patients know how secure messaging and patient portal can make their lives easier, they will use it and they will see the benefits. I would never go back to any other method, and more and more patients are signing up each month. Purchasing a expensive running shoes doesn't automatically make you a faster runner- you have to put some effort into it if you want to see results. And you will see results.

  5. Agree with the more positive comments ... Have my own portal through Medfusion .. a bit clunky but patients are constantly using it.

  6. great info !!