Intended for healthcare professionals

Information In Practice

Email consultations in health care: 1—scope and effectiveness

BMJ 2004; 329 doi: (Published 19 August 2004) Cite this as: BMJ 2004;329:435
  1. Josip Car, doctoral student in patient-doctor partnership1,
  2. Aziz Sheikh, professor of primary care research and development (
  1. 1 Department of Primary Care and Social Medicine, Imperial College London, London W6 8RP
  2. 2 Division of Community Health Sciences: GP Section, University of Edinburgh, Edinburgh EH8 9DX
  1. Correspondence to: A Sheikh

    Electronic communication promises to revolutionise the delivery of health care. In the first of two articles considering the potential for email consultations, Car and Sheikh summarise the evidence about their use for preventive health care, health education, and managing non-urgent conditions


    In 1971 Ray Tomlinson programmed and sent the first email message. Widespread public use began in the early 1990s and rapidly spread to the extent that email now represents an integral part of daily life for about 60% of the UK population (fig 1). The popularity of email stems largely from its user friendliness, efficiency, and versatility in facilitating asynchronous communication (see box 1).1

    Fig 1

    Trends in home access to the internet in UK households. Most people use the internet for email communication. (Data source: National Statistics Omnibus Survey 2003)

    Increased opportunities for electronic communication have revolutionised many industries and customer services, such as banking and retail, but email's promise for improving delivery of health care remains largely untapped.1 2 In this two part review, we consider the use of email for communication in a clinical context. The first article explores the scope for email consultations for preventive health care, health education, and managing non-urgent conditions. Our second article summarises the evidence describing public and professional attitudes to using email in health care and considers how to ensure its safe use in routine clinical care.

    Information sources and selection criteria

    We used established systematic review methods to identify systematic reviews and original research studies evaluating the role of email communication in health care.w1 We searched the Cochrane Library, Embase, and Medline (from 1980 to 2003) and scrutinised bibliographies of identified articles in order to identify additional published material. We searched the internet using general and specialised search engines to identify “grey” literature from sources such as industry reports, legal and strategic …

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