1. If a clinician and a patient agree to use electronic mail, patients should be informed about privacy issues. Patients should know that:

2. Clinical interactions conducted by email which a clinician believes should be part of the medical record will be stored in the patient's electronic or paper medical record.

3. If the patient’s health information/treatment includes particularly sensitive information, ask the patient to decide whether this information may be referenced in email, or should not be shared.

Such information might include references to HIV status, substance abuse, sexually-transmitted diseases, sexual assault, cancer, abortion, domestic violence, or confidential details of treatment with a psychotherapist, psychologist or social worker. Until the patient’s preference is known, content of this kind in an email should be avoided.

4. Patients should be asked to write the category of transaction, e.g., status, appointment, in the subject line of a message so that clinicians can more easily sort and prioritize their emails.

5. When available, clinicians and patients should use encryption technology for transmitting patient identifiable information. Judgment should be used in the type of medical information that is transmitted, recognizing the increased vulnerability. A digital ID will be used when possible.

6. When possible, clinicians and patients should use a Read Receipt in order to acknowledge that they have read the message that was sent.

7. Patient-identifiable information should not be forwarded to a third party (non-clinician) without the patient’s prior consent.