Emails and death: Legal issues surrounding post-mortem transmission of emails

The paper is a first thorough examination of what happens to one's emails on death. The paper demonstrates that some content of emails can be protected by copyright and transmitted on death accordingly. The paper then analyzes the contractual provisions of the main email providers, Google and Microsoft, in order to determine how these contracts, regulate the transmission of emails on death. The author finds that these provisions complicate the issues of property and transmission of digital assets and do not offer a meaningful control over the assets for their users. The paper adopts a novel focus introduced in the author's earlier research, the idea of post-mortem privacy that is the right to privacy after death. This concept serves as an argument against the default transmission of emails on death without the deceased's consent, whether through the laws of intestacy or by requiring the service providers to provide access to the deceased's emails. Finally, the paper canvasses a solution which combines law and technology. It is argued that much more control should be placed in the hands of emails users. Post-mortem privacy, a potentially contested phenomenon, only accentuates the need to better account for the interests of the deceased, having in mind the volume of personal data and personal nature of emails. Therefore, an in-service solution is promoted, backed up by policy and legislation.

Professional e-mail communication among health care providers: proposing evidence-based guidelines

E-mail is now a primary method of correspondence in health care, and proficiency with professional e-mail use is a vital skill for physicians. Fundamentals of e-mail courtesy can be derived from lay literature, but there is a dearth of scientific literature that addresses the use of e-mail between physicians. E-mail communication between providers is generally more familiar and casual than other professional interactions, which can promote unprofessional behavior or misunderstanding. Not only e-mail content but also wording, format, and tone may influence clinical recommendations and perceptions of the e-mail sender. In addition, there are serious legal and ethical implications when unprofessional or unsecured e-mails related to patient-identifying information are exchanged or included within an electronic medical record. The authors believe that the appropriate use of e-mail is a vital skill for physicians, with serious legal and ethical ramifications and the potential to affect professional development and patient care. In this article, the authors analyze a comprehensive literature search, explore several facets of e-mail use between physicians, and offer specific recommendations for professional e-mail use.

Social work practice in the digital age: therapeutic e-mail as a direct practice methodology

The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include the potential to reach clients in geographically remote and underserved communities, enhancing and extending the therapeutic relationship and improving treatment outcomes. Risks include threats to client confidentiality and privacy, liability coverage for practitioners, licensing jurisdiction, and the lack of competency standards for delivering e-mail interventions. Currently, the social work profession does not have adequate instructive guidelines and best-practice standards for using e-mail as a direct practice methodology. Practitioners need (formal) academic training in the techniques connected to e-mail exchanges with clients. The author describes the ethical and legal risks for practitioners using therapeutic e-mail with clients and identifies recommendations for establishing best-practice standards.

What's that, you say? Employee expectations of privacy when using employer-provided technology--and how employers can defeat them

Two 2010 court cases that determined the effectiveness of policies governing employees' use of employer-provided communication devices can be used to guide employers when constructing their own technology policies. In light of a policy that stated that "users should have no expectation of privacy or confidentiality," one case established that the employer was in the right. However, a separate case favored the employee due, in part, to an "unclear and ambiguous" policy. Ultimately, employers can restrict the use of employer-furnished technology by employees by: 1) clearly outlining that employees do not have a reasonable expectation of privacy in their use of company devices; 2) stating that any use of personal e-mail accounts using employer-provided technology will be subject to the policy; 3) detailing all technology used to monitor employees; 4) identifying company devices covered; 5) not exposing the content of employee communications; and 6) having employees sign and acknowledge the policy.

Widespread adoption of information technology in primary care physician offices in Denmark: a case study

Denmark is one of the world's leading countries in the use of health care technology. Virtually all primary care physicians have electronic medical records with full clinical functionality. Their systems are also connected to a national network, which allows them to electronically send and receive clinical data to and from consultant specialists, hospitals, pharmacies, and other health care providers. Under the auspices of a nonprofit organization called MedCom, over 5 million clinical messages are transferred monthly. One of the most important innovations has been the "one-letter solution," which allows one electronic form to be used for all types of letters to and from primary care physicians; it is used in over 5,000 health institutions with 50 different technology vendor systems.

2009 electronic claim requirements for Minnesota dentists

This article explains Minnesota Statute 62J.536, which is a new law requiring all health care providers and payers doing business in Minnesota to use electronic formats for billing, eligibility, and remittance advice. The focus of this article is on dentists and what they must do to be in compliance.

An analysis of the utilization of e-mail by physicians and patients: defining benefits, addressing concerns and forecasting implications on the doctor-patient relationship

Though e-mail is ubiquitous in everyday life, it has not been the preferred mode of communication between physicians and patients. Several factors, including privacy and security, reimbursement and legal concerns, have been seen as barriers toward increased utilization. This article examines effect of e-mail on the doctor-patient relationship. It also addresses concerns expressed by providers and patients, and explores technology- and policy-based solutions to many of these issues.

Secure e-mail applications: strengthening connections between adolescents, parents, and health providers

Although e-mail has become a popular means of communication among consumers, particularly youth, available evidence suggests that current use of this modality to facilitate communication between consumers and their health providers is relatively modest. Historically, structural and legal issues have provided substantial impediments; however, new developments in providing secure and protected mechanisms for transmitting and delivering e-mail messages may pave the way to enhance use and improve communication.

Use or abuse of computers in the workplace

Is your computer system about to become your next liability by the misuse of computers in the workplace? "E-discovery" reveals evidence of harassment, discrimination, defamation, and more. Yet employees also sue when the employer improperly intercepts electronic messages the employees claim were "private." Employers need to be aware of the issues of use, misuse, and rights to properly monitor and control the electronic system. Learn the current issues, legal trends, and practical pointers for your electronic operations.

Legislative barriers to outpatient e-prescribing in a randomized trial

Newer outpatient electronic prescribing software programs produce typewritten paper prescriptions with electronically created signatures. Current Canadian federal legislation forbids static (unchanging) signature images on prescriptions. We conducted a randomized trial of electronic prescribing in outpatients at a university-affiliated hospital. The application was a wireless Palm-based system that creates a prescription that is either printed and given to the patient or faxed to a pharmacy. Using the software, the physician creates a unique signature image for each prescription. We successfully overcame challenges related to wireless network reliability, local printer availability and physician training. However, to comply with federal legislation and provincial regulations, we were required to design workarounds to create acceptable prescribing processes. Our experience suggests that the legality of the electronic signature must be clearly defined to realize the full potential of standalone outpatient electronic prescribing systems and fully integrated hospital-wide electronic medical records.

“You’ve got mail!”: The role of e-mail in clinical breast surgical practice

Easy Internet access is changing the practice of medicine in the US. At least 137 million Americans have access to the World Wide Web, and up to one-half would like to communicate with their physicians by e-mail. The membership of the American Society of Breast Surgeons was surveyed to evaluate the current role of e-mail in patient-doctor relationships. Due to the extensive discussions often involved in the evaluation of breast disease, and the elective nature of most surgical procedures, this specialty may be particularly well-suited to using e-mail communication as an extension of discussions during traditional office visits. A questionnaire was e-mailed to all members of the ASBS who had provided an e-mail address. About 1236 questionnaires were sent, and 285 surgeons responded, a 23% response rate. About 130 (46%) responders were female; 209 responders (73%) did not use e-mail to communicate with patients (76% of responding females, 70% of males). The oldest and youngest surgeons were least likely to use e-mail to communicate with patients. There was no gender-related difference in e-mail use. There was no difference in e-mail use between surgeons who limit their practice to breast disease and those who do not. Urban and university-based surgeons were more likely to use e-mail. Medical-legal liability concerns and confidentiality issues were the most common reasons for not using e-mail. Among those surgeons who did use e-mail, ability to answer at one's own discretion, and the ability to provide an organized response were the major reasons for using e-mail. Overall, the membership expressed a preference for personal interaction over electronic communication.

Informed Consent to E-Therapy

E-therapy, the provision of mental health treatment through the Internet, poses many risks as well as benefits. This article addresses some relevant risks and benefits of e-therapy and discusses the practicality of using computers in the informed consent process. Although e-therapy has numerous proponents, no clinical trials have assessed its long-term effectiveness. To limit liability and to protect patients, e-therapy providers should disclose material risks as well as possible benefits and engage patients in an active dialogue. A thorough informed consent procedure enables patients to make an educated decision about whether e-therapy is right for them. In the future, e-therapy and informed consent online may become more common; in the mean time, clinicians must be prepared for e-therapy's uncertain legal status and allow patients to decide for themselves whether or not to seek counseling on the Internet.

E-mail communication between pediatricians and their patients

This report addresses specific e-mail patient communication issues relevant to pediatricians and their appropriate use of e-mail in the office setting. The report briefly reviews: 1) e-mail privacy and security concerns; 2) e-mail in the office environment; 3) the legal status of e-mail; and 4) available e-mail technologic solutions.

E-mail consultation: clinical, financial, legal, and ethical implications

BACKGROUND

Communication via e-mail has become widespread. Nearly every practicing neurosurgeon is confronted with numerous unsolicited e-mail requests for medical advice, guidance, or information. Neurosurgeons need to be aware of the clinical, financial, legal, and ethical implications of providing medical consultation via e-mail.

METHODS

A literature review of the penetration of e-mail consultation in medical practice was performed. The data on the potential for reimbursement for provision of these services is presented. Precedents for legal liability are discussed, and issues of compliance with HIPAA regulations are reviewed.

RESULTS

Communication between patients and physicians via e-mail is increasing in prevalence, and a substantial number of physicians are providing medical information via e-mail consultation. Billing for online consultation has been approved by the American Medical Association, and several medical insurance carriers are evaluating the economic consequences of reimbursement for e-mail consultation. E-mail consultation raises potential medico-legal concerns, including establishment of the physician-patient relationship, malpractice liability, and HIPAA compliance.

CONCLUSIONS

The increasing prevalence of e-mail consultation raises new concerns for neurosurgeons. Some of these concerns have yet to be addressed by regulatory commissions or in the courts. If used appropriately, e-mail communication can facilitate physician-patient interactions, improve access to care, save time for each interaction, and possibly reduce costs of care.

Legal concerns surrounding e-mail use in a medical practice

The Internet and e-mail have revolutionized the way people communicate with others, but they have not been embraced in medical practice because of legal concerns. To date, there have been no malpractice cases concerning e-mail, but e-mail is in its infancy for practitioner-patient communication. E-mail can be implemented in medical practice to enhance the practitioner-patient relationship, but only if there are safeguards to protect both the patient and the practitioner.