Wednesday, May 30, 2007

Caution on e-mailing patients

This is the first article of a review of this important topic of doctor-patient communications that I will like to share with my colleagues. Your feedback is welcome.

Ingrid Alicea, M.D.
Secretary, Puerto Rico Psychiatric Society




"The Interactive Office: the office of the future"

The use of the internet and e-mails by physicians is increasing as a form of communication. Standards for appropriate and effective use are imperative. I will like to review the "AMA Guidelines for Doctor-Patient e-mail."


The American Medical Association Board of Trustees recommends that for those physicians who choose to utilize e-mails for selected patient and medical practice communications, the following communication guidelines be adopted.



1. Establish turnaround time for messages. Exercise caution when using
e-mail for urgent matters.

2. Inform patients about privacy issues.
Patients should know who besides addressee processes messages
during addressee’s usual business hours and during
addressee’s vacation or illness.

Whenever possible and appropriate, physicians should retain electronic
and/or paper copies of e-mails communications with patients.

3. Establish types of transactions (prescription refill,
appointment scheduling, etc.) and sensitivity of subject
matter (HIV, mental health, etc.) permitted over e-mail.

4. Instruct patients to put the category of transaction in the
subject line of the message for filtering:
prescription, appointment, medical advice, billing question.

5. Request that patients put their name and patient
Identification number in the body of the message.

6. Configure automatic reply to acknowledge receipt of messages.

7. Send a new message to inform patient of completion of request.

8. Request that patients use autoreply feature to acknowledge
reading clinicians message.

9. Develop archival and retrieval mechanisms.

10. Maintain a mailing list of patients, but do not send group
Mailings where recipients are visible to each other. Use blind
copy feature in software.

11. Avoid anger, sarcasm, harsh criticism, and libelous references
to third parties in messages.

12. Append a standard block of text to the end of e- mail messages
to patients, which contains the physician’s full name,
contact information, and reminders about security and
the importance of alternative forms of communication
for emergencies.

13. Explain to patients that their messages should be concise.

14. When e-mail messages become too lengthy or the correspondence
is prolonged, notify patients to come in to discuss or call them.

15. Remind patients when they do not adhere to the guidelines.

16. For patients who repeatedly do not adhere to the guidelines,
it is acceptable to terminate the e-mail relationship.

Saturday, May 26, 2007

La APA colabora en Puerto Rico

Actividades en el 2006

Reception Winter Institute Sun 8-Jan-2006

Public Health and Society:The Caribbean and U.S. Connection Mon 9-Jan-2006

Reunion Academia de Psiquiatria Tue 10-Jan-2006

Reunion Directiva de la APA de Puerto Rico Tue 17-Jan-2006

Reunion sobre Ley de Salud Mental Tue 7-Feb-2006 at 9:00am

Programa radial en WKVM, Lo ultimo sobre antipsicoticos atipicos Thu 23-Feb-2006 at 6:30pm

WPA-APAL Meeting Caracas 2006 Thu 23-Mar-2006

APA Assembly 2006 Fri 19-May-2006

2006 APA Annual Meeting

Congreso APAL 2006 Wed 1-Nov-2006

September 2006

APA presenta: Alternativas al sistema de salud mental de PR Sat 2-Sep-2006
Pedro Ruiz, MD segundo hispano presidente de la Asociacion Psiquiatrica Americana
y lideres de la psiquiatria de Puerto Rico opinan sobre el sistema de salud mental
de Puerto Rico. Hotel Condado Plaza, Condado, Puerto Rico 2 de septiembre del 2006.

Tercera Convencion Anual APRIP Fri 8-Sep-2006
Tercera Convencion Anual de la Asociacion de PSiquiatras Egresados del Instituto de Psiquiatria de Puerto Rico. Hotel Paradisus, Rio Grande, PR del 8 al 10 de septiembre del 2006

Advances in Psychiatry in Puerto Rico
Sat 16-Sep-2Nueva organizaciòn Sociedad Puertorriqueña de Psiquiatrìa.
Ritz Carlton Hotel, Isla Verde, PR
Cinco creditos de educacion medica.006 at 12:30pm

Sexualidad adolescente Mon 25-Sep-2006 at 7:30pm
Programa de radio de la Puerto Rico Psychiatric Society. WKVM 810AM Servicio Publico, orientacion a la comunidad por la radio.

October 2006
PROCLAMA DEL MES DE LA SALUD MENTAL Mon 2-Oct-2006 at 8:00am
La Junta de Directores de NAMI PUERTO RICO
Le invita a asistir a los actos oficiales de la PROCLAMA DEL MES DE LA SALUD MENTAL Y DIA NACIONAL DE ORACION POR LA SALUD MENTAL
El lunes 2 de octubre de 2006 8:00 AM a 12:00 Mediodia
En el Centro de Convenciones Los Chavales, 253 Avenida F.D. Roosevelt, Hato Rey PR

Sobre el abuso de ninos Mon 2-Oct-2006 at 7:30pm
Programa de radio en WKVM 810AM auspiciado por la Puerto Rico Psychiatric Society,
Capitulo en Puerto Rico de la Asociacion Psiquiatrica Americana.

Reunion Cap de Psiquiatria Colegio Medicos Tue 3-Oct-2006 at 7:00pm
El Colegio de Medicos Cirujanos contiene a todos los psiquiatras de Puerto Rico.

Psiquiatria a nivel privado, los retos Mon 9-Oct-2006 at 7:30pm Por WKVM 810AM en la radio. Programa semanal del Capitulo de PR de la Asocacion Psiquiatrica Americana.

Reunion Academia de Psiquiatria Tue 10-Oct-2006 at 6:30pm

Conferencia Magistral sobre la Esquizofrenia Sat 14-Oct-2006 at 9:00am
Centro De Convenciones Los Chavales, en Hato Rey. Esta Conferencia forma parte del programa de actividades del Mes de la Salud Mental.

VAMOS A CRECER: primer programa Sun 15-Oct-2006 at 4:00pm
http://www.vamosacrecer.blogspot.com

Por Radio Isla el Dr. Nestor J Galarza entrevista y comparte con el publico radio oyente desde una perspectiva positiva de crecimiento.
Con 30 años de experiencia como psiquiatra y dotado de la cultura puertorriqueña por 60 años se
dispone a conversar con usted sobre asuntos que atañen a la salud mental de los ciudadanos de Puerto Rico.
Este primer programa dedicado a las ideas del Dr. Osvaldo Rosario, profesor de quimica analitica y ambiental en la UPR.

Tratamientos alternos y convencionales Mon 16-Oct-2006 at 7:30pm
Programa radial semanal del Capitulo de PR de la Asociacion Psiquiatrica Americana.
PR Psychiatric Society, APA in PR meeting Tue 17-Oct-2006 at 7:00pm
El Capitulo de la http://www.psych.org. Veala.
Vamos a crecer Sun 22-Oct-2006 at 4:00pm
Radio Isla donde el Dr. Nestor J Galarza entrevista al pasado Secretario de Salud
de Puerto Rico Enrique Vazquez Quintana. Haciendo preguntas dificiles.

Esquizofrenia: Con tu salud en mente Mon 23-Oct-2006 at 7:30pm
Weekly broadcast of the Puerto Rico Psychiatric Society
Tema de esta fecha: La esquizofrenia y la recuperacion de esta enfermedad
por Nestor J Galarza, MD, psiquiatra por los ultimos 30 a�os.

Radio Isla: La guerra y sus victimas Sun 29-Oct-2006 at 4:00pm
El Dr. Hector Rivera Gonzalez, presidente del Comite de salud Mental
del Colegio de Medicos Cirujanos opina sobre la guerra, otros traumas y las victimas

WKVM: El Divorcio y los ninos Mon 30-Oct-2006 at 7:30pm
WKVM presenta en Con tu salud en mente a la Dra. Dalila Aguilu
en una entrevista sobre como el divorcio afecta a los ninos y las cosas positivas de algunos divorcios.

November 2006

Reunion Cap Psiq Colegio MedicosCirujanos Tue 7-Nov-2006 at 6:30pm
Abuso de ninos; causas y soluciones Sun 12-Nov-2006 at 4:00pm
Lea: http://www.vamosacrecer.blogspot.com

Bipolar o drogodependiente? Mon 13-Nov-2006 at 7:30pm
Lea: http://www.vamosacrecer.blogspot.com

Convencion anual del Colegio de Medicos Thu 16-Nov-2006 at 2:00pm
En el Hotel Conquistador de Fajardo. Incluye educacion continuada

Convencion Psiquiatria Thu 16-Nov-2006 at 2:00pm
APA Executive Commitee meeting Tue 21-Nov-2006 at 7:00pm

December 2006

Educacion Continua del Colegio de Medicos Cirujanos Sat 9-Dec-2006 at 1:00pm until 12:00pm (Expires on 12/10/2006)

Encuentro con Dr. Victor Bernal y del Rio Sat 9-Dec-2006 at 3:00pm
el lider del adiestramiento de la mayor parte de los psiquiatras en Puerto Rico,
se regocija con el orgullo que sientes sus discipulos,
quienes aportan a la salud mental en Puerto Rico por muchos a�os.

Vamos a crecer, alternativas a la violencia Sun 10-Dec-2006 at 4:00pm
El Dr. Raul Lopez, el Dr. Galarza e invitados hablan de las alternativas
de altura a la violencia en Puerto Rico. Por radio isla 1320. Escuchela tambien por
la internet en radioisla1320.com

Reunion Directiva PRPS Tue 19-Dec-2006 at 7:00pm
La ultima reunion de la directiva de la APA en Puerto Rico, celebrando
la ejecutoria en el ambito de la educacion publica y la aportacion a la ley de salud mental.

Actividades en el 2007

January 2007

PR Psychiatric Society Exective Commitee Meeting Tue 16-Jan-2007 at 7:00pm

Grupo Estudios psicoanaliticos Sat 27-Jan-2007 at 9:00am
Estudios Psicoanal�tico Interdisciplinario de PR, s�bado 27 de enero del 2007 9am Edificio Barat Norte de la Universidad del Sagrado Coraz�n

February 2007

Election of officers Puerto Rico Psychiatric society Tue 20-Feb-2007

Long Term Utilization of Anti-Psychotics Thu 22-Feb-2007 at 6:00pm

Gala Dinner Colloquium
Long Term Utilization of Anti-Psychotics:
Cutting Edge Pearls of Wisdom on Indications and Benefits vs. Risks and Complications
Alan Mendelowitz from the National Institute of Mental Health.

Modelo innovador psicoanalitico Wed 28-Feb-2007 at 6:00pm until 9:00pm
The Puerto Rico Psychiatric Society, a chapter of the American Psychiatric Association
sponsored the Seminar Innovative Model for Psychoanalytic Treatment of Psychoses
by Clinic 388 Quebec, Canada on February 28, 2007 at the auditorium of the University of
Puerto Rico School of Medicine.

The Puerto Rico Psychiatric Society was the most important grantor to cover the costs of this important activity. The seminar discussed the integration of different modalities of care and the cost effectiveness of this treatment model.

March 2007
Board Meeting: Psych Chapter Colegio Medicos Cirujanos Tue 6-Mar-2007 at 7:00pm

VAMOS A CRECER Sun 11-Mar-2007
Por radio isla 1320 desde su casa o automobil y por la internet en http://www.radioisla1320.com

Board Meeting: Academia de Psiquiatria de Puerto Rico Mon 12-Mar-2007 at 6:00pm

Meeting Psychoanalytic Study Group Sat 17-Mar-2007 at 9:00am

Board meeting: PR Psych Society Tue 20-Mar-2007 at 6:00pm