- Health care organisations can use email to communicate with patients – as long as they take reasonable steps to ensure patient privacy.
- Always seek and document the patient’s consent before sending their personal information using email.
- Implementing clear practice policies can help avoid privacy and patient safety breaches.
Can you use email to communicate with patients?
Patients are increasingly expecting their doctors to
communicate via email as it is often easier and more convenient
for them. Consultations via telehealth rely increasingly on email
to communicate with patients and other health professionals.
However, you may worry about whether you can send
information by email or you may think that you can only use
In fact, privacy legislation does not prescribe how you or any
health care organisation should send health information to
patients or third parties. The law states that any method of
communication can be used so long as you take reasonable
steps to protect the privacy of the patient and the security of
their health information. So, yes, you can email your patients.
Satisfying your privacy obligations – reasonable steps
The Office of the Australian Information Commissioner (‘OAIC’
– which includes Australia’s Privacy Commissioner) has outlined
the steps it considers reasonable for organisations to take when
communicating by email in its Guide to Securing Personal Information. In line with this guide, we recommend:
1. Email encryption is ideal but not essential
Using encryption is the safest way to send an email and you
should use it wherever possible.
However, the OAIC does not insist that healthcare organisations
use encryption as a minimum standard in all cases. Rather, you
need to “develop procedures to manage the transmission of
personal information via email”, recognising that email is not
necessarily a secure form of communication.
You do need to consider the type of information and whether it
is appropriate to send by unsecured email, or whether you need
to take additional steps to protect it by attaching the information as a PDF document with a password. How you provide the
appropriate password to the patient is another consideration,
but options could include a separate email, an SMS or something
elected by the patient and stored in your system.
2. Have a clear policy
Just because it is easy to send an email does not mean it is
appropriate. For this reason, you need to develop practice policies
about the appropriate use of email to communicate with patients.
All staff need to be clear about what they can and cannot send by
email, and the steps they need to take if they are using email.
Even if your practice does not correspond by or encourage
email, you may still receive email from patients, so it is important
that your policies address how email will be managed.
3. Make sure you have patient consent
You may need to send information by email, for example as part
of a telehealth consultation, or in response to a patient request.
In this case, you should advise the patient about the risks
associated with unencrypted email and confirm they still wish to
have the information sent in that way.
Ideally, you would get patient consent in writing. If that is not
practical, make sure you get the patient’s verbal consent and
document it in their clinical record.
However, when sending a patient information via email, if you
have any concerns about their understanding and informed
consent about the specific email, reconfirm details and consent
with patient prior to sending.
4. Check the address before pressing send
The OAIC consistently reports that private information being
sent to the wrong recipient accounts for around one in 10
Another emerging theme is errors involving auto-complete –
where software programs default to recently or frequently
Other sources of error could involve misheard or mistyped email
addresses, or accidentally using ‘reply all’.
Patients may have more than one email address. They may not
want information sent to a work or shared email for example,
so make sure you check which address they want you to use.
Useful tip to avoid incorrect email address
To avoid such errors, you could ask the patient to email you
requesting the information and giving consent to reply using
email. This serves both as a record of the patient’s consent and
confirmation of their preferred email address.
5. Password protect sensitive information
Your policy needs to address whether and how you will send
particular types of information, for example results, prescriptions,
Some clinical or sensitive information should ideally be sent
in a password-protected file. You will need to make this
determination. In this case, make sure you take care to avoid
including sensitive information in the body of the email.
Your process also needs to include a protocol for providing the
password (for example, phone the patient with the password).
6. Use a privacy disclaimer
The best course is to avoid sending email to unintended
recipients. However, it is useful to have a privacy disclaimer on all
emails leaving the practice as an additional protection.
Document email in medical records
As with any communication, your process needs to ensure
incoming emails are passed onto the appropriate person,
actioned, documented in the patient’s clinical record and
managed in accordance with record-keeping requirements.
Make sure your policy also addresses how clinical images sent to
a practitioner, (for example as part of a telehealth consultation)
will be used and stored. For more information please see Avant’s
factsheet: Storing, retaining and disposing of medical records.
Is email ever inappropriate?
Even if your patient consents to communication by email,
there may be circumstances in which you are not comfortable
emailing them the information. It may be particularly sensitive
or detailed or need a complex explanation. It is always
appropriate to exercise your clinical judgement to decline to
send such information by email. You may consider a face-to-face
consultation is necessary (in limited circumstances, telehealth
may be suitable).
We would consider it inappropriate to deliver any bad news to a
patient via electronic means.
You may also find that a patient responds to an email with
further questions. Try to avoid back-and-forth conversations
over email because there is a risk that these will turn into a chain
of correspondence and you may find yourself providing medical
advice without a proper consultation. In such situations, it is
appropriate to decline to respond further via email and ask the
patient to make an appointment.
Ensure email communication with your patients is only provided in accordance with your indemnity insurance policy, as there may be requirements such as having had a previous in person consultation.
Email link on your website
Delegate the task to an employee to monitor the emails being
sent to the practice via the website email link. You can use
keywords to block certain emails. For example, you could use
a keyword filter such as ‘test’ that will result in the email being
blocked and a message would be sent to the sender asking
them to contact the practice to make an appointment.
Consider patient safety
You can send time sensitive information by email, but you do
need some safeguards in place to be sure the information
has been received and actioned. You might ask the patient to
acknowledge receipt of any email communication either by a
generated ‘read receipt’ or a manual return email, depending on
Urgent after-hours emails
Practices are not required to check email addresses 24 hours
a day. However, you do need to be clear about how the
account is being monitored, particularly if you publish the
address anywhere, such as on your website. You could outline
when email will be responded to and include an auto-reply
advising how the address is being monitored and providing an
appropriate emergency contact.
You can find additional resources including articles, podcasts
and webinars in the Avant Learning Centre under technology or
Download the factsheet