THE ORIGIN, CONTENT, AND WORKLOAD OF E-MAIL CONSULTATIONS

Context.-Despite the common use of e-mail, little beyond anecdote or i mpressions has been published on patient-clinician e-mail consultation . Objective.-To report our experiences with free-of-charge e-mail cons ultations.Design.-Retrospective review of all e-mail consultation requ ests received between November 1, 1995, and June 31, 1998. Setting and Participants.-Consecutive e-mail consultation requests sent to the Di vision of Pediatric Gastroenterology at the Children's Medical Center of the University of Virginia in Charlottesville. Main Outcome Measure s.-Number of consultation requests per month, time required to respond , who initiated the request and their geographic origin, and the kind of information requested in the consultation. Results.-During the 33-m onth period studied, we received 1239 requests, an average (SD) of 37. 6 (1 5.9) each month. A total of 1001 consultation requests (81%) were initiated by parents, relatives, or guardians, 126 (10%) by physician s, and 112 (9%) by other health care professionals. Consultation reque sts were received from 39 states and 37 other countries. In 855 reques ts (69%), there was a specific question about the cause of a particula r child's symptoms, diagnostic tests, and/or therapeutic interventions . In 112 (9%), the requester sought a second opinion about diagnosis o r treatment for a particular child, and 272 consultations (22%) reques ted general information concerning a disorder, treatment, or medicatio n without reference to a particular child. A total of 1078 requests (8 7%) were answered within 48 hours of the initial request. On average, reading and responding to each e-mail took slightly less than 4 minute s.Conclusion.-E-mail provides a means for parents, guardians, and heal th care professionals to obtain patient and disease-specific informati on from selected medical consultants in a timely manner.