Vocabulary

Electronic health record (EHR): A computerized software system that maintains patient health information, which can be created, managed, and consulted by authorized healthcare professionals and providers from more than one healthcare organization.

Patient portal: A secure online website designed for patients to access their health information and to communicate with their provider.

Protected health information (PHI): Includes a patient’s identifiable demographic information, physical and/or mental health information and conditions and related payment information. Under HIPAA, the security, privacy, and confidentiality of PHI must be safeguarded.

Communicating through Professional Emails

The use of electronic communication has increased over the last years in ambulatory care. Healthcare providers and staff not only communicate among themselves and their agency, but also with their patients. With the use of patient portals, patients can send email messages to their provider. Many times the provider has the medical assistant send a response to the patients. Knowing how to send business emails is an essential skill for healthcare professionals.

Email Confidentiality and Security

Patients commonly communicate via email using the patient portal software. Responding to patients’ emails is usually done by the medical assistant based on feedback from the provider. A copy of the communication from and to the patient must be included in the electronic health record (EHR). This communication is confidential. The healthcare professional must follow the state and federal laws that address patient confidentiality.

Email communication with patients must also be secure. Healthcare agencies must use software that encrypts email communication, making the data nonreadable. This prevents unauthorized users from accessing the communication.

Email Etiquette

Email etiquette involves the social guidelines that govern interactions that occur when emailing people. Healthcare agencies may have additional policies and procedures when staff interact with patients through emails. All emails should be addressed and responded to in a timely manner. By following email etiquette and the agency’s policies, the healthcare professional can provide customer-friendly communication with patients.

Addressing an Email

When addressing an email, the user should do the following:

• Use a semicolon (;) between email addresses, when sending an email to multiple people.
• Use the Cc line if a copy of the email needs to be sent to another person. Make sure the person cc’d has a right to see the email contents and the patient’s confidentiality will not be breached.
• Use the Bcc line if a copy of the email needs to be sent to another person without the knowledge of the people listed in the To and Cc fields. Use the Bcc field sparingly.
• Ensure the email address(es) used are correct to avoid sending the email to an incorrect person.
• Add a short, specific topic in the subject line. If the email was forwarded, delete any strings in the subject line, such as RE: and FWD:.

Composing the Email

To create a professional email, use standard font and formatting. Start the email with a formal salutation (greeting), which includes the person’s title and name followed by a colon (:). For example, a formal greeting would be “Dear Mrs. Black:” or “Good morning, Mr. Smith:.” Add a blank line between the greeting (salutation) and the first line of the body of the email.

The body of the email messages should be polite, professional, and courteous. This can be achieved by using such words as “would you care to”, “please”, “if possible”, or similar words. It is also important to thank the recipient at the end of the message. The email message should be accurate, clear, and concise. Leave a blank line between each paragraph in the body and then between the last line of the body and the closing.

Many options exist for the closing in a professional email. These include: “Regards”, “Kind regards”, “Thank you”, “Best”, and “Sincerely.”   On the next line, type your full name and credential (e.g., CMA, RN) (Box 1). Many healthcare facilities require employees to include the facility’s contact information below their name. The contact information usually includes the healthcare facility’s name, address, phone number, and fax number.

Additional tips when writing professional emails, include:

• Use proper capitalization, grammar, punctuation, and sentence structure. Remember that the recipient may view the writer as “shouting” if all capital letters are used.
• Spell check the email before sending it.
•  Do not use emoticons (emojis). Write out the entire word, and refrain from using abbreviations.

Sending Emails

When sending attachments with emails, the user must consider the file size. If a large file size needs to be sent, the file should be zipped. Zip is a software that compresses the folder or file, making it easier to send and receive. The recipient must use an unzip program to extract the folder or file.

Many email programs allow special features, such as:

• Delivery receipt: The sender receives an email when the email is delivered.
• Read receipt: A read receipt may be sent to the writer of the email, when the recipient opens the email. The recipient may have the option to send or decline the read receipt.
• Importance: The sender can also select the level of importance of the email. The recipient sees the importance level.

When forwarding messages, use caution. Always read the entire email to ensure the content is appropriate to be forwarded. Ensure that a patient’s confidentiality will not be breached.

Communicating during Virtual Meetings

Virtual meetings have increased in popularity since 2020. Company meetings, job interviews, and patient visits are now just some of the meetings that can be done with this technology. Virtual meetings allow the participants to communicate and see each other, while being at a distance. A virtual meeting requires using a webcam, a microphone, an internet connection, and video conference software, such as Zoom, Microsoft Teams, or tools in the patient portal.

Preparing for a Virtual Meeting

When preparing for a virtual meeting, the host must send an invitation out to the participants. This is done using the video conference software. Each participant must ensure they have the software and hardware (e.g., webcam, microphone) available to use.

When participating in a professional meeting, such as a business meeting, an interview, or patient visit, it is important to consider the background environment that others will see. Some software allows the user to blur the background or to add a digital background picture. If these options are not available, then it is important to have a neutral background, like a blank wall. In the healthcare environment, no patient information should be visible during virtual meetings to prevent a breach in confidentiality. Taking a virtual meeting in a quiet room can help limit environmental noises.

It is important to consider the position of the webcam and the monitor. Is the webcam too close or too far away from the participant? Is the webcam located in a position, so the participant looks like they are making eye contact when looking at their screen? Having the screen (monitor) at a different angle than the webcam creates the impression that the participant is not focusing on the meeting.

Etiquette During a Virtual Meeting

To help the virtual meeting go smoothly, it is helpful for the host to establish guidelines. For meetings with a larger number of attendees, microphones are typically muted prior to the start of the meeting and after the introductions.

The host will indicate how attendees can ask questions or talk. For instance, they may need to pose questions in the chat area of the software or virtually raise their hand (a feature in some software). Some hosts ask that attendees introduce themselves prior to asking their question or adding their thoughts to the topic being discussed. This helps the attendees identify who is talking.

Additional etiquette includes:

• Speak naturally and clearly. Do not shout or talk louder than normal.
• Limit the environmental noise on your end. When listening, having a side conversation, or typing, ensure your mute button is on.
• Allow the speaker to complete their thought, before talking. Sometimes lag time occurs during virtual meetings. So wait for about two seconds after the speaker finishes, before talking.
• Do not eat during a virtual meeting, unless the host indicates the participants can do so.
• Ensure you are dressed professionally.
• Look at the camera during the meeting.

Communicating through Fax

The fax or facsimile technology has been around for a long time. When a person faxes a document to another person, an electronic image of the document is transmitted as data by telecommunication links. The document the person receives is called a fax or facsimile.

A document can be faxed using one of three ways:

• Using a fax machine: Stand-alone fax machines or copy machines with a fax feature have been available for years. When using a fax machine, refer to the manufacturer’s directions for the faxing procedure. When the document is delivered, the sender usually gets a printed receipt. It is important to remove the documents that were faxed.
• Using a mobile device:  After installing a mobile fax application (app), the sender may need to create an account, providing their personal and payment information. To create a fax, enter the recipient’s fax number, including the area code. Attach the document to be faxed and preview the information to ensure everything is correct before sending the fax. A confirmation message will appear with the fax that is sent.
• Using a computer: Fax software must be installed and configured on the computer prior to sending a fax. To send a fax, click on the New Fax button and enter the recipient’s fax number in the “To” field. Attach the document to be faxed. Preview the content before clicking the Send button.

Faxing Patient Documents

When faxing patient documents, healthcare professionals must follow the agency’s policies and procedures. They must also adhere to the rules established by the Health Insurance Portability and Accountability Act (HIPAA). When using a fax machine, most healthcare procedures require the use of a cover sheet, which is the first sheet of the fax.

The cover sheet includes a confidentiality note indicating that if the recipient gets the fax in error, they need to destroy the documents and contact the sender. The cover sheet also includes the sender’s and recipient’s names, companies, and contact information. It may include the date and the number of sheets in the fax. Remember to include the cover sheet in the total page count.

Communicating using Social Media

Social media are websites or apps that allow the user to create, post, and share information to the social network. Common social media sites include Facebook, TikTok, LinkedIn, and Instagram. Social media can be used for business or personal related posts.

The Use of Social Media by Healthcare Facilities

Healthcare facilities use social media for a variety of reasons including:

• Attracting new employees
• Conducting research with those who use social media
• Promoting their healthcare services
• Educating the public on health related topics
• Hosting support groups for specific populations, such as those dealing with cancer
• Promoting awareness and advocating for public policy changes

Personal Posts on Social Media

Many people have personal social media sites. It is important to remember that content posted on these sites can be viewed by others, including supervisors and potential employers. During the hiring process, many agencies will review the potential employee’s presence on social media sites. Depending on the security restrictions applied to one’s social media account, a person who is not a “friend” may learn a lot from viewing another person’s social media postings.

Guidelines to follow when working in healthcare:

• Do not share confidential information about the healthcare facility
• Do not share patient information, including pictures and health data. Under HIPAA, an individual’s protected health information (PHI) cannot be used or disclosed without the individual’s authorization. The PHI includes any treatment, health, or payment information that identifies the individual.
• Be clear that you are speaking for yourself and not representing the healthcare facility
• Do not befriend patients or their family members on social media
• Use sound judgement when posting. Refrain from posting negative content about healthcare providers, professionals, or supervisors
• Do not post on social media while working.

Being Safe on Social Media

Many people post where they are, who they are with, pictures and other personal information on social media. They know their friends will see the posting, but who else can view the information?

According to the National Security Agency, the following strategies should be followed to keep information safe on social media:

• Review and update the social media’s privacy settings. This should be done initially and then after each update to ensure the settings have not been reset.
• Protect the location data. Many apps on mobile devices ask for location permission and other resources. These features are not used to run the app and gather and transmit data that can expose the person’s location. To protect one’s location data, disable the location services setting on mobile devices. Do not give your location away on social media platforms, such as using “check-in”. Limit the permissions given to apps.
• Verify ”friend” requests. Social media accounts can be duplicated or copied for spear-phishing or malicious intentions. Confirm that social contacts and friends sent the “friend request” and only accept these requests. Never accept requests from people who you do not know.
• Do not post or give out critical information. To reset passwords, most sites require the user to answer specific questions. Such as “the name of your first pet”, “the middle name of your oldest sibling”, or “the city you were born in”. Be cautious of the information you post. Do not take surveys that ask for personal information. Information from these surveys could be used to access and compromise accounts.

Learning Activities